韩国的外科住院医师制度：对医院成本和术后结果影响的初步研究。

A surgical hospitalist system in Korea: a preliminary study of the effects on hospital costs and postoperative outcomes.

作者信息

Jung Yoon Bin, Jung Eun-Joo, Lee Kang Young

机构信息

Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Ann Surg Treat Res. 2021 May;100(5):298-304. doi: 10.4174/astr.2021.100.5.298. Epub 2021 Apr 29.

DOI:10.4174/astr.2021.100.5.298

PMID:34012948

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8103155/

Abstract

PURPOSE

The aim of this study is to investigate the effect of the surgical hospitalist system on postoperative outcomes and hospital costs for surgical patients.

METHODS

We reviewed the medical records of 522 patients who were admitted to the divisions of colorectal and gastrointestinal surgery for operation from September to December 2017 at Severance Hospital, Yonsei University College of Medicine in Seoul, Korea. All patients were divided into 2 groups; one that was managed by surgical hospitalists group (HG) and another that was managed by non-hospitalist residents group (NHG) after elective surgery. Postoperative outcomes and hospital costs were analyzed for each group.

RESULTS

Two hundred ninety-eight patients were managed by HG and 189 patients were managed by NHG after surgery. The length of hospital stay in the first group was shorter (9.6 ± 5.8 days 12.2 ± 7.9 days, P < 0.001), the incidence of complications was lower (44.6% 55.6%, P = 0.019), and the readmission rate was lower (3.0% 6.9%, P = 0.046) in the HG than in the NHG. The difference in total hospital costs was not significant between the HG and the NHG (₩8,381,304 ₩9,242,493, P = 0.559), but surgery-independent hospital costs were lower in the HG than in the NHG (₩3,020,873 ₩3,923,308, P = 0.001).

CONCLUSION

The surgical hospitalist system reduced the length of hospital stay, the incidence of postoperative complications, and the readmission rates of surgical patients. This led to the effect of a reduction in total hospital costs.

摘要

目的

本研究旨在探讨外科住院医师制度对外科手术患者术后结局及住院费用的影响。

方法

我们回顾了2017年9月至12月在韩国首尔延世大学医学院Severance医院结直肠和胃肠外科接受手术的522例患者的病历。所有患者分为两组；一组由外科住院医师管理（HG组），另一组在择期手术后由非住院医师管理（NHG组）。分析每组的术后结局和住院费用。

结果

术后HG组管理298例患者，NHG组管理189例患者。HG组的住院时间较短（9.6±5.8天对12.2±7.9天，P<0.001），并发症发生率较低（44.6%对55.6%，P = 0.019），再入院率较低（3.0%对6.9%，P = 0.046）。HG组和NHG组的总住院费用差异无统计学意义（8,381,304韩元对9,242,493韩元，P = 0.559），但HG组的非手术相关住院费用低于NHG组（3,020,873韩元对3,923,308韩元，P = 0.001）。