Division of Hospital Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California.
Quantitative Sciences Unit, Division of Biomedical Informatics Research, Department of Medicine, Stanford University School of Medicine, Stanford, California.
J Hosp Med. 2020 Apr 1;15(4):232-235. doi: 10.12788/jhm.3363. Epub 2020 Feb 11.
Surgical comanagement (SCM), in which surgeons and hospitalists share responsibility of care for surgical patients, has been increasingly utilized. In August 2012, we implemented SCM in Orthopedic and Neurosurgery services in which the same Internal Medicine hospitalists are dedicated year round to each of these surgical services to proactively prevent and manage medical conditions. In this article, we evaluate if SCM was associated with continued improvement in patient outcomes between 2012 and 2018 in Orthopedic and Neurosurgery services at our institution. We conducted regression analysis on 26,380 discharges to assess yearly change in our outcomes. Since 2012, the odds of patients with ≥1 medical complication decreased by 3.8% per year (P = .01), the estimated length of stay decreased by 0.3 days per year (P < .0001), and the odds of rapid response team calls decreased by 12.2% per year (P = .001). Estimated average direct cost savings were $3,424 per discharge.
外科共管（SCM），即外科医生和医院医师共同负责外科患者的护理，已得到越来越多的应用。2012 年 8 月，我们在骨科和神经外科服务中实施了 SCM，内科医院医师全年专门负责这两项外科服务，以主动预防和管理医疗状况。在本文中，我们评估了在我们机构的骨科和神经外科服务中，SCM 是否与 2012 年至 2018 年期间患者预后的持续改善相关。我们对 26380 次出院进行了回归分析，以评估我们各项结果的年度变化。自 2012 年以来，每年患有≥1 种医疗并发症的患者的几率降低 3.8%（P =.01），估计住院时间每年减少 0.3 天（P <.0001），快速反应团队呼叫的几率每年降低 12.2%（P =.001）。每次出院的估计平均直接成本节省为 3424 美元。
