Knowlton Lisa Marie, Scott John W, Dowzicky Phillip, Murphy Patrick, Davis Kimberly A, Staudenmayer Kristan, Martin R Shayn
From the Section of Trauma, Surgical Critical Care and Acute Care Surgery, Department of Surgery (L.M.K., K.S.), Stanford University School of Medicine, Stanford, California; Department of Surgery (J.W.S.), Division of Trauma, Burn, and Critical Care Surgery, University of Washington, Seattle, Washington; Department of Surgery (P.D.), Division of Trauma and Acute Care Surgery, University of Chicago, Chicago, Illinois; Department of Surgery (P.M.), Division of Trauma/Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin; Section of Acute Care Surgery, Department of Surgery (K.A.D.), Division of General Surgery, Yale University, New Haven, Connecticut; and Department of Surgery (R.S.M.), Wake Forest School of Medicine, Winston-Salem, North Carolina.
J Trauma Acute Care Surg. 2024 Jun 1;96(6):986-991. doi: 10.1097/TA.0000000000004310. Epub 2024 Mar 13.
Acute care surgery (ACS) patients are frequently faced with significant long-term recovery and financial implications that extend far beyond their hospitalization. While major injury and emergency general surgery (EGS) emergencies are often viewed solely as acute moments of crisis, the impact on patients can be lifelong. Financial outcomes after major injury or emergency surgery have only begun to be understood. The Healthcare Economics Committee from the American Association for the Surgery of Trauma previously published a conceptual overview of financial toxicity in ACS, highlighting the association between financial outcomes and long-term physical recovery. The aims of second-phase financial toxicity review by the Healthcare Economics Committee of the American Association for the Surgery of Trauma are to (1) understand the unique impact of financial toxicity on ACS patients; (2) delineate the current limitations surrounding measurement domains of financial toxicity in ACS; (3) explore the "when, what and how" of optimally capturing financial outcomes in ACS; and (4) delineate next steps for integration of these financial metrics in our long-term patient outcomes. As acute care surgeons, our patients' recovery is often contingent on equal parts physical, emotional, and financial recovery. The ACS community has an opportunity to impact long-term patient outcomes and well-being far beyond clinical recovery.
急性护理手术(ACS)患者常常面临重大的长期康复问题以及远超住院期间的经济影响。虽然重大创伤和急诊普通外科(EGS)急症通常仅被视为急性危机时刻,但对患者的影响可能是终身的。重大创伤或急诊手术后的经济后果才刚刚开始被人们所认识。美国创伤外科学会医疗保健经济委员会此前发表了一篇关于ACS中经济毒性的概念性概述,强调了经济后果与长期身体康复之间的关联。美国创伤外科学会医疗保健经济委员会进行的第二阶段经济毒性审查的目的是:(1)了解经济毒性对ACS患者的独特影响;(2)明确当前围绕ACS中经济毒性测量领域的局限性;(3)探索在ACS中最佳获取经济后果的“时间、内容和方式”;(4)明确将这些经济指标纳入我们长期患者预后评估的后续步骤。作为急性护理外科医生,我们患者的康复往往取决于身体、情感和经济康复的同等程度。ACS领域有机会对长期患者预后和福祉产生影响,且这种影响远远超出临床康复范畴。