青少年特发性脊柱侧凸矫正术后综合强化康复（TIGER）方案可降低直接成本和住院时间，同时提高日贡献边际。
Team Integrated Enhanced Recovery (TIGER) Protocol after Adolescent Idiopathic Scoliosis Correction Lowers Direct Cost and Length of Stay While Increasing Daily Contribution Margins.
机构信息
University of Missouri - Columbia School of Medicine Department of Orthopaedic Surgery (UMC SOM DOS), Harry S. Truman Veterans Hospital, Columbia, Missouri.
University of Missouri - Columbia School of Medicine Department of Orthopaedic Surgery (UMC SOM DOS), Columbia, Missouri.
出版信息
Mo Med. 2022 Mar-Apr;119(2):152-157.
INTRODUCTION
Posterior spinal fusion (PSF) is the gold standard procedure for curve correction in Adolescent Idiopathic Scoliosis (AIS). Enhanced recovery protocols (ERPs) have been found to decrease pain and hospital length of stay (LOS) resulting in decreased total hospital charges.
METHODS
We identified all adolescent idiopathic scoliosis patients treated with a posterior spinal fusion at our children's hospital between 2015-2019. Length of stay, pain scores, and hospital direct costs were calculated to determine the pathway's efficacy.
RESULTS
Hospital LOS was reduced by 26% and post-op pain scores did not significantly change when using the Team Integrated Enhanced Recovery (TIGER) protocol (P<0.05). Total hospital costs decreased by 7.9%, daily contribution margins increased 7.9%, and daily net income increased 10.6% after TIGER protocol implementation.
CONCLUSION
TIGER protocol resulted in decreased hospital LOS as well as direct costs for the hospital without increasing postoperative pain scores.
简介
后路脊柱融合术（PSF）是青少年特发性脊柱侧凸（AIS）曲度矫正的金标准。增强康复方案（ERPs）已被发现可减轻疼痛并缩短住院时间（LOS），从而降低总住院费用。
方法
我们在 2015 年至 2019 年间，在儿童医院对所有接受后路脊柱融合术治疗的青少年特发性脊柱侧凸患者进行了识别。计算了住院时间、疼痛评分和医院直接费用，以确定该方案的疗效。
结果
使用 Team Integrated enhanced Recovery（TIGER）方案后，住院时间缩短了 26%，术后疼痛评分无显著变化（P<0.05）。TIGER 方案实施后，医院总费用降低了 7.9%，每日贡献边际增加了 7.9%，每日净收入增加了 10.6%。
结论
TIGER 方案可缩短住院时间并降低医院的直接成本，而不会增加术后疼痛评分。
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