Belza Caitlyn C, Lopes Kelli, Benyamein Paige, Harfouche Cyril, Dean Riley, Geter Santaria, Lee Clara J, Neubauer Dan, Reid Chris M, Suliman Ahmed, Gosman Amanda A
From the School of Medicine, University of California San Diego, San Diego, Calif.
Division of Plastic Surgery, University of California San Diego, La Jolla, Calif.
Plast Reconstr Surg Glob Open. 2024 Oct 23;12(10):e6250. doi: 10.1097/GOX.0000000000006250. eCollection 2024 Oct.
The aesthetic plastic surgery industry has seen tremendous growth, with Americans spending an estimated 20 billion dollars on procedures in 2020. However, the effect of complications from these procedures on the healthcare system is poorly understood. This study aims to create awareness regarding aesthetic procedure complications through the scope of plastic surgeons at a tertiary medical facility.
A retrospective chart review was performed on patients who received care at a single academic tertiary referral center over 5 years for complications from a cash-paid aesthetic procedure at an outside facility. Physician and hospital billing data were analyzed for relevant encounters.
Patients in this study (n = 40) presented to the emergency department most frequently with complications secondary to abdominoplasty (35%), breast augmentation (27.5%), and injectable fillers (17.5%). The most common complications were infection (32.5%) and wound dehiscence (22.5%). Of those evaluated, 50% required inpatient admission. Additionally, 42.5% required surgical intervention. The distribution of payors included Medicaid (55%), commercial insurance (30%), and Medicare (7.5%), and 7.5% were uninsured. For physician billing, the total gross collection ratio was 21.3%, whereas the hospital billing total gross collection ratio was 25.16%.
Larger referral hospitals are well-suited to support the aesthetic community with complication management; however, the care required to serve this population is resource-intensive. These data advocate for thorough closed-loop patient-surgeon communication regarding risk-benefit analysis and detailed courses of action should complications arise. Likewise, stronger communication between ambulatory surgical centers and tertiary referral centers may also help minimize complications and subsequent healthcare needs.
美容整形手术行业发展迅猛，2020年美国人在整形手术上的花费估计达200亿美元。然而，这些手术并发症对医疗系统的影响却鲜为人知。本研究旨在通过一家三级医疗机构的整形外科医生的视角，提高对美容手术并发症的认识。
对在一家学术性三级转诊中心接受治疗的患者进行回顾性病历审查，这些患者在5年内因外部机构的自费美容手术出现并发症。分析医生和医院的计费数据以获取相关诊疗情况。
本研究中的患者（n = 40）最常因腹部整形术（35%）、隆胸术（27.5%）和注射填充剂（17.5%）引发的并发症前往急诊科就诊。最常见的并发症是感染（32.5%）和伤口裂开（22.5%）。在接受评估的患者中，50%需要住院治疗。此外，42.5%需要手术干预。支付方的分布包括医疗补助（55%）、商业保险（30%）和医疗保险（7.5%），7.5%的患者未参保。在医生计费方面，总收款率为21.3%，而医院计费的总收款率为25.16%。
大型转诊医院非常适合在并发症管理方面为美容领域提供支持；然而，为这部分人群提供服务所需的护理资源密集。这些数据提倡就风险效益分析以及并发症发生时的详细行动方案进行全面的闭环患者 - 外科医生沟通。同样，门诊手术中心和三级转诊中心之间加强沟通也可能有助于减少并发症及后续的医疗需求。
