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一项评估在面临财务压力的卫生服务机构中外科医生成本意识的研究。

A study evaluating cost awareness amongst surgeons in a health service under financial strain.

机构信息

Department of Upper Gastrointestinal Surgery, Beaumont Hospital, Beaumont Road, Beaumont, Co. Dublin, Ireland.

Department of Upper Gastrointestinal Surgery, Beaumont Hospital, Beaumont Road, Beaumont, Co. Dublin, Ireland.

出版信息

Int J Surg. 2018 Aug;56:184-187. doi: 10.1016/j.ijsu.2018.06.027. Epub 2018 Jun 20.

Abstract

BACKGROUND

Despite having considerable influence over resource allocation clinicians possess poor knowledge of healthcare costs. This study evaluated surgeons' cost-awareness with regard to surgical equipment and assessed attitudes towards health economics training using survey format.

MATERIALS AND METHODS

An online survey was distributed to 326 surgeons across a range of specialties in Ireland. Respondents were asked about their surgical expertise, previous training in health economics, and its role in the surgical curriculum. They were also asked to estimate the recommended retail price (RRP) of 17 commonly used items of surgical equipment. Answers within ±25% of the RRP were considered correct.

RESULTS

Of 140 respondents, 62 (44.3%) were on a surgical training scheme and 16 (11.4%) were consultants. Overall, surgeons correctly estimated the RRP of only 14.0% of items. There was no difference in accuracy between surgeons in later years of training compared to their junior counterparts (13.1 ± 8.8% versus 15.0 ± 8.8%, p = 0.115). The highest individual score was six out of 17 items correctly estimated. Participants overestimated the cost of low-cost items by 347.7% and underestimated the cost of high-cost items by 35.5%. Only 5.7% of participants had received undergraduate training in health economics but 75.0% felt it should be included in the curriculum. Over two-thirds said their practice would change if they had better knowledge of the cost of surgical equipment.

CONCLUSION

The majority of surgeons receive little training in health economics and have poor knowledge of the cost of surgical equipment. Most would welcome more training at both an undergraduate and postgraduate level. An opportunity exists to promote cost awareness in the operating room, which could lead to a reduction in waste and improved use of resources.

摘要

背景

尽管临床医生对资源分配有相当大的影响力,但他们对医疗成本的了解却很差。本研究通过问卷调查的形式评估了外科医生对手术设备成本的认识,并评估了他们对卫生经济学培训的态度。

材料和方法

向爱尔兰各地不同专业的 326 名外科医生发放了在线调查问卷。要求受访者介绍自己的手术专长、以前接受过的卫生经济学培训及其在外科课程中的作用。他们还被要求估计 17 种常用手术设备的建议零售价(RRP)。答对率在 25%以内的被认为是正确的。

结果

在 140 名回答者中,62 名(44.3%)正在接受外科培训计划,16 名(11.4%)是顾问。总的来说,外科医生正确估计 RRp 的只有 14.0%的项目。在培训后期的外科医生与他们的初级同行相比,准确性没有差异(13.1±8.8%对 15.0±8.8%,p=0.115)。个人最高得分为 17 项中正确估计 6 项。参与者高估了低成本项目的成本,高估了 347.7%,低估了高成本项目的成本,低估了 35.5%。只有 5.7%的参与者接受过卫生经济学本科培训,但 75.0%的人认为应该将其纳入课程。超过三分之二的人表示,如果他们更了解手术设备的成本,他们的做法将会改变。

结论

大多数外科医生接受的卫生经济学培训很少,对手术设备的成本了解甚少。大多数人欢迎在本科和研究生阶段接受更多的培训。有机会在手术室中提高成本意识,这可能导致浪费减少和资源更好地利用。

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