心脏、胸科和结直肠手术中患者参与技术（PET）的成本效益分析。
Cost-benefit analysis of a patient engagement technology (PET) in cardiac, thoracic, and colorectal surgery.
机构信息
Division of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Division of Cardiothoracic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
出版信息
Am J Surg. 2022 Sep;224(3):979-986. doi: 10.1016/j.amjsurg.2022.04.030. Epub 2022 Apr 26.
BACKGROUND
Patient engagement technologies (PETs) guide patients through perioperative care, but little is known about their costs-benefits.
METHODS
Retrospective cohort study of patients undergoing elective colorectal, cardiac, thoracic surgery 2015-2020. PET was implemented 2018. Patients were propensity-matched in pre-PET, PET, non-PET groups. Costs of surgical encounter and 30 days post-discharge, mortality, length-of-stay, readmissions, complications, satisfaction were compared.
RESULTS
Overall, 4,373 patients underwent surgery and 607 (13.9%) patients enrolled in the PET. PET patients did not have increased costs in any specialty. Colorectal PET patients' variable costs of surgical encounter were $102 lower than non-PET, $1495 lower than pre-PET (p = 0.03). Thoracic PET patients' total costs of surgical encounter were $9224 lower than non-PET, $2187 lower than pre-PET (p = 0.03). Thoracic PET patients had lower mean LOS (2.4 days, 5.1 non-PET, 3.1 pre-PET, p = 0.03). PET patient satisfaction ranged 86.0%-97.8%.
CONCLUSIONS
Use of a PET did not increase costs and was associated with benefits for patients undergoing elective surgery.
背景
患者参与技术（PET）指导患者进行围手术期护理，但对于其成本效益知之甚少。
方法
回顾性队列研究了 2015 年至 2020 年期间接受择期结直肠、心脏、胸外科手术的患者。2018 年实施了 PET。在 PET 前、PET 中、非 PET 组中进行倾向匹配。比较手术和 30 天出院后的成本、死亡率、住院时间、再入院率、并发症、满意度。
结果
总体而言，4373 名患者接受了手术，607 名（13.9%）患者参加了 PET。任何专业的 PET 患者都没有增加成本。结直肠 PET 患者手术费用的变动成本比非 PET 患者低 102 美元，比 PET 前低 1495 美元（p=0.03）。胸科 PET 患者的手术总费用比非 PET 患者低 9224 美元，比 PET 前低 2187 美元（p=0.03）。胸科 PET 患者的平均住院时间较短（2.4 天，5.1 非 PET，3.1 PET 前，p=0.03）。PET 患者的满意度在 86.0%至 97.8%之间。
结论
使用 PET 不会增加成本，并为接受择期手术的患者带来益处。
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