Ciudin Alexandru, Padulles Bernat, Manasia Pasqualino, Alcoberro Josep, Ounia Sanae, Lopez Maria, Allue Natalia, Ferrer Joan Maria, Duran Jaume, Aguilar Antonio
Urology Department, Hospital Universitari de Mollet, 08100 Barcelona, Spain.
Hospital Management, Hospital Universitari de Mollet, 08100 Barcelona, Spain.
Diagnostics (Basel). 2023 Mar 4;13(5):986. doi: 10.3390/diagnostics13050986.
(1) Background: The diagnosis of moderate-severe lower urinary tract symptoms (LUTS) is not easy due to the complexity of the micturition act. Sequential diagnostic tests can be time consuming due to waiting lists. Thus, we developed a diagnostic model combining all the tests in a single one-stop consultation. (2) Methods: In a prospective pilot study in patients with complex LUTS, they received all diagnostic tests (ultrasound, uroflowmetry, cystoscopy, pressure-flow study) in a single consultation and by the same doctor. Patients' results were compared with those from a 2021 paired cohort that underwent the classical sequential diagnostic pathway. (3) Results: Per patient, the high-efficiency consultation saved: 175 days of waiting, 60 min doctor time and 120 nursing assistant time and over 300 euros on average. The intervention also saved 120 patient journeys to the hospital, lowering the total carbon footprint by 145.86 kg CO. In one-third of the patients, performing all the tests within the same consultation contributed to reaching a more appropriate diagnosis and thus more effective treatment. Patients' satisfaction was high, with good tolerability. (4) Conclusions: The high-efficiency urology consultation improves waiting times, therapeutic decisions and the degree of patient satisfaction while optimizing the use of resources and generating savings for the health system.
(1) 背景:由于排尿行为的复杂性,中重度下尿路症状(LUTS)的诊断并不容易。由于等候名单,序贯诊断测试可能耗时较长。因此,我们开发了一种诊断模型,将所有测试整合在一次一站式会诊中。(2) 方法:在一项针对复杂LUTS患者的前瞻性试点研究中,他们在一次会诊中由同一位医生接受了所有诊断测试(超声、尿流率测定、膀胱镜检查、压力-流率研究)。将患者的结果与2021年接受经典序贯诊断途径的配对队列的结果进行比较。(3) 结果:每位患者通过高效会诊节省了:175天的等候时间、60分钟的医生时间和120分钟的护理助理时间,平均节省超过300欧元。该干预措施还减少了患者120次往返医院的行程,使总碳足迹降低了145.86千克二氧化碳。在三分之一的患者中,在同一次会诊中进行所有测试有助于做出更恰当的诊断,从而实现更有效的治疗。患者满意度高,耐受性良好。(4) 结论:高效泌尿外科会诊改善了等候时间、治疗决策和患者满意度,同时优化了资源利用并为卫生系统节省了费用。