Davis Matthew J, Luu Bryan C, Raj Sarth, Abu-Ghname Amjed, Buchanan Edward P
Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA; Division of Plastic Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX, USA.
Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
Surgeon. 2021 Feb;19(1):49-60. doi: 10.1016/j.surge.2020.02.005. Epub 2020 Mar 24.
Multidisciplinary care has been shown to improve outcomes for patients, and interprofessional collaboration has been demonstrated to be beneficial for providers. In the field of surgery, although a large number of multidisciplinary care teams have been described, no study to date has examined whether or not these team-based interventions are generally cost-effective. This is the first systematic review to examine cost savings attributable to multidisciplinary care across all surgical fields.
A comprehensive literature review of articles published on cost outcomes associated with multidisciplinary surgical teams was performed. Selected articles reported on cost outcomes directly attributable to a collaborative intervention. Cost savings were totaled on a per-patient basis. Each article was also reviewed to determine whether the authors ultimately recommended the team-based intervention described.
A total of 1421 articles were identified in the initial query, of which 43 met inclusion criteria. Thirty-nine studies (91%) reported multidisciplinary care to be cost effective, with an average cost savings among all studies of $5815 per patient. No significant differences in the amount of savings achieved were found between different intervention subtypes. All studies ultimately recommended (40) or gave mixed reviews (3) of multidisciplinary care, regardless of whether cost savings were achieved.
Multidisciplinary surgical care is beneficial not only in terms of patient and provider outcomes, but also in reference to its cost-effectiveness. Well-designed multidisciplinary teams tend to optimize perioperative care for all involved parties. Efforts to improve surgical care should employ multidisciplinary teams to promote both quality and cost-effective care.
多学科护理已被证明可改善患者的治疗效果,跨专业协作也已证明对医疗服务提供者有益。在外科领域,尽管已描述了大量多学科护理团队,但迄今为止尚无研究探讨这些基于团队的干预措施总体上是否具有成本效益。这是第一项系统评价,旨在研究所有外科领域中多学科护理带来的成本节约情况。
对发表的有关多学科外科团队成本结果的文章进行了全面的文献综述。所选文章报告了直接归因于协作干预的成本结果。按每位患者计算成本节约的总和。还对每篇文章进行了审查,以确定作者最终是否推荐所描述的基于团队的干预措施。
在初始查询中总共识别出1421篇文章,其中43篇符合纳入标准。39项研究(91%)报告多学科护理具有成本效益,所有研究中每位患者的平均成本节约为5815美元。不同干预亚型之间在节约金额方面未发现显著差异。所有研究最终都推荐(40项)或对多学科护理给出了混合评价(3项),无论是否实现了成本节约。
多学科外科护理不仅在患者和医疗服务提供者的治疗效果方面有益,而且在成本效益方面也有益。精心设计的多学科团队倾向于为所有相关方优化围手术期护理。改善外科护理的努力应采用多学科团队以促进高质量和具有成本效益的护理。