Sethi Rosh K V, Deschler Daniel G
Department of Otolaryngology, Harvard Medical School, Boston, MA, United States; Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA, United States.
Department of Otolaryngology, Harvard Medical School, Boston, MA, United States; Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA, United States.
Am J Otolaryngol. 2018 Sep-Oct;39(5):553-557. doi: 10.1016/j.amjoto.2018.06.010. Epub 2018 Jun 7.
Operating room (OR) procedures represent one quarter of hospitalizations, yet OR-related stays account for nearly 50% of hospital costs. Understanding trends in inpatient parotidectomy, associated charges, and key outcomes including length of stay is imperative in the era of evolving health reform.
The Nationwide Inpatient Sample (NIS) was queried for patients who underwent inpatient parotidectomy (ICD9-CM procedure code 26.31 and 26.32) between 2001 and 2014. Patient demographics, co-morbidities, hospital characteristics and outcomes including length of stay (LOS) and hospital charges were assessed.
A total of 66,914 parotidectomies were performed in the inpatient setting between 2001 and 2014. The volume of inpatient parotidectomy decreased steadily by 48% over the study period (7375 procedures in 2001 to 3530 procedures in 2014). Average LOS increased from 1.8 days in 2001 to 2.5 days in 2014. Total charges increased from $17,072 in 2001 to $55,929 in 2014. In 2014, the majority of inpatient parotidectomies were performed in a teaching hospital (87%) and among patients who were older than 65 years (48.1%). In 2001, only 35.4% of patients who underwent parotidectomy were older than age 65, and relatively fewer surgeries were performed at teaching hospitals (63.1%).
Inpatient parotidectomy in the United States has evolved over the past fourteen years. Notable trends include a nearly 50% reduction of inpatient surgery, doubling in LOS, tripling of hospital charges and predominance of elderly patients with malignant disease. These results provide insight into inpatient parotid lesion management.
手术室（OR）手术占住院治疗的四分之一，但与手术室相关的住院时间却占医院成本的近50%。在不断发展的医疗改革时代，了解住院腮腺切除术的趋势、相关费用以及包括住院时间在内的关键结果至关重要。
查询全国住院患者样本（NIS）中2001年至2014年间接受住院腮腺切除术（ICD9-CM手术编码26.31和26.32）的患者。评估患者的人口统计学特征、合并症、医院特征以及包括住院时间（LOS）和医院费用在内的结果。
2001年至2014年间，住院环境下共进行了66914例腮腺切除术。在研究期间，住院腮腺切除术的数量稳步下降了48%（从2001年的7375例手术降至2014年的3530例手术）。平均住院时间从2001年的1.8天增加到2014年的2.5天。总费用从2001年的17072美元增加到2014年的55929美元。2014年，大多数住院腮腺切除术在教学医院进行（87%），且患者年龄在65岁以上（48.1%）。2001年，接受腮腺切除术的患者中只有35.4%年龄超过65岁，在教学医院进行的手术相对较少（63.1%）。
美国住院腮腺切除术在过去十四年中有所演变。显著趋势包括住院手术减少近50%、住院时间翻倍、医院费用增至三倍以及老年恶性疾病患者占主导。这些结果为住院腮腺病变的管理提供了见解。
