学术型与非学术型健康中心对手术创新的采用。
The Adoption of Surgical Innovations at Academic Versus Nonacademic Health Centers.
机构信息
H.L. Yeo is assistant professor of surgery, Departments of Surgery and Healthcare Policy and Research, Weill Cornell Medical College, and assistant attending surgeon, NewYork-Presbyterian/Weill Cornell Medical Center, New York, New York. R. Kaushal is chair, Department of Healthcare Policy and Research, executive director, Center for Healthcare Informatics and Policy, and Nanette Laitman Distinguished Professor of Healthcare Policy and Research, Weill Cornell Medicine, New York, New York. She is also chief, Healthcare Policy and Research, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York. L.M. Kern is associate professor of medicine, Joan and Sanford I. Weill Department of Medicine, and associate professor of healthcare policy and research, Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York.
出版信息
Acad Med. 2018 May;93(5):750-755. doi: 10.1097/ACM.0000000000001932.
PURPOSE
The value of the health care services provided by academic health centers (AHCs) in the United States increasingly is being questioned. AHCs play a prominent role in developing new surgical innovations, including new minimally invasive techniques, which are costly up front but can lead to significant benefits like decreased morbidity and lengths of stays. This study explored the role of AHCs in the adoption of these surgical innovations as a novel measure of their value.
METHOD
The authors combined data from the American Hospital Association and the State Inpatient Databases from California, Florida, Washington State, and New York. They compared the number and percentage of patients who received four new, innovative surgical procedures (vs. those who received the traditional procedures) at Council of Teaching Hospitals (COTH) hospitals to those at non-COTH hospitals from 2009 to 2011.
RESULTS
Overall, 61.1% (27,175) of the procedures performed at COTH hospitals used new techniques, compared with 47.2% (41,680) at non-COTH hospitals, across all years (P < .0001). The number and percentage of procedures using the new techniques increased in all years and for all procedures.
CONCLUSIONS
Not only do AHCs play a role in developing surgical innovations but they also adopt these new techniques more quickly than other hospitals, and thereby they provide additional benefits to patients. These findings provide an important and understudied perspective on the value of AHCs.
目的
美国学术医疗中心（AHC）所提供的医疗服务的价值正日益受到质疑。AHC 在开发新的外科创新方面发挥着突出的作用，包括新的微创手术，这些创新在前期成本较高，但可以带来显著的益处，如降低发病率和住院时间。本研究探讨了 AHC 在采用这些外科创新方面的作用，这是衡量其价值的一个新方法。
方法
作者将美国医院协会和加利福尼亚州、佛罗里达州、华盛顿州和纽约州的州住院患者数据库的数据结合起来。他们比较了 2009 年至 2011 年期间，在教学医院理事会（COTH）医院接受四种新的创新外科手术（与接受传统手术的患者相比）的患者数量和百分比，以及非 COTH 医院的相应数据。
结果
总体而言，在所有年份（P<0.0001），COTH 医院使用新技术的手术比例为 61.1%（27,175），而非 COTH 医院为 47.2%（41,680）。所有年份和所有手术中，使用新技术的手术数量和百分比都在增加。
结论
AHC 不仅在开发外科创新方面发挥作用，而且比其他医院更快地采用这些新技术，从而为患者提供了额外的益处。这些发现为 AHC 的价值提供了一个重要而被低估的视角。
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