治疗肱骨髁上骨折的成本和教育体验：标准化手术护理的初步分析
The Cost and Educational Experience of Treating Supracondylar Humerus Fractures: A Pilot Analysis on Standardizing Surgical Care.
机构信息
Department of Orthopedic Surgery (Dr. Su, Dr. Lee), Connecticut Children's Medical Center, University of Connecticut, Hartford, CT, and the Department of Orthopedic Surgery (Dr. Su), Nemours Alfred I. duPont Hospital for Children, Wilmington, DE.
出版信息
J Am Acad Orthop Surg Glob Res Rev. 2020 Jun 1;4(6). doi: 10.5435/JAAOSGlobal-D-20-00063. eCollection 2020 Jun.
UNLABELLED
Closed reduction and percutaneous pinning (CRPP) for supracondylar humeral fractures (SCHF) comprised considerable surgical volume in pediatric orthopaedics. Limited reports are available on how standardization of the surgical care affects the cost and trainee's learning experience.
METHODS
Cost analysis was performed by chart review with the billing department in a university teaching hospital. The association of cost with perioperative variables was determined by univariate and multivariable analyses. The educational experience was acquired by questionnaires completed by seven attending surgeons and 22 orthopaedic trainees.
RESULTS
Fifty-one patients were included, revealing the hospital charge of $6,345 per CRPP case. Most of the cost comprised OR time (67%) and anesthesia time (13%). The attending surgeon and fracture type were independently associated with anesthesia time. Standardization of care was perceived for better learning experience and cost saving.
CONCLUSION
Efforts in the standardization of SCHF surgical care can improve cost saving and trainees' learning experience.
目的
经皮克氏针固定术（CRPP）治疗儿童肱骨髁上骨折（SCHF）在小儿矫形外科中占有相当大的手术量。关于手术护理标准化如何影响成本和学员学习体验的报告有限。
方法
在一所大学教学医院，通过与计费部门的图表审查进行成本分析。通过单变量和多变量分析确定成本与围手术期变量的关系。通过七位主治医生和 22 名骨科学员完成的问卷调查获得教育经验。
结果
共纳入 51 例患者，显示每例 CRPP 病例的医院费用为 6345 美元。大部分成本包括手术室时间（67%）和麻醉时间（13%）。主治医生和骨折类型与麻醉时间独立相关。护理标准化被认为可以获得更好的学习体验和节省成本。
结论
SCHF 手术护理标准化的努力可以节省成本并提高学员的学习体验。
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