Stanwick R S, Horne J M, Peabody D M, Postuma R
CMAJ. 1987 Jul 1;137(1):21-6.
The cost-effectiveness for parents of day-care pediatric surgery was assessed by comparing time and financial costs associated with two surgical procedures, one (squint repair) performed exclusively as a day-care procedure, the other (adenoidectomy) performed exclusively as an inpatient procedure. All but 1 of 165 eligible families participated. The children underwent surgery between February and July 1981. The day-care surgery group (59 families) incurred average total time costs of 16.1 hours, compared with 37.1 hours for the inpatient surgery group (105 families), as parents in the latter group remained with their child during the longer hospital stay. Parents from out of town incurred the greater time and financial costs. In both groups parents of younger children tended to spend more time at the hospital than parents of older children. Type of surgical management was not a significant factor in out-of-pocket expenses. Loss of income was associated with employment of the mother as a professional or a manager and may reflect inequalities in access to compassionate leave between men and women in equivalent positions. Opening day-care surgery facilities on weekends might reduce the financial burden on working mothers. Overall, day-care surgery was found to be cost-effective for families.
通过比较两种手术相关的时间和财务成本,评估了日间小儿外科手术对家长的成本效益,其中一种手术(斜视修复)完全作为日间手术进行,另一种手术(腺样体切除术)完全作为住院手术进行。165个符合条件的家庭中,除1个家庭外,其余家庭均参与了研究。这些孩子于1981年2月至7月接受了手术。日间手术组(59个家庭)的平均总时间成本为16.1小时,而住院手术组(105个家庭)为37.1小时,因为住院时间较长,后者组的家长需一直陪伴孩子。来自外地的家长产生的时间和财务成本更高。在两组中,年幼孩子的家长往往比年长孩子的家长在医院花费更多时间。手术管理类型并非自付费用的重要因素。收入损失与母亲从事专业或管理工作有关,这可能反映了同等职位男女在获得陪产假方面的不平等。在周末开设日间手术设施可能会减轻职业母亲的经济负担。总体而言,日间手术对家庭具有成本效益。