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可膨胀阴茎假体植入术后减少术后随访的经济影响

Economic impact of reduced postoperative visits after inflatable penile prosthesis implantation.

作者信息

Gill Bradley, Shin Young Eun, Durand Kathryn, Sun Andrew, Babbar Paurush, Rojanasarot Sirikan

机构信息

Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, USA.

Department of Urology, Cleveland Clinic, Cleveland, OH, USA.

出版信息

J Comp Eff Res. 2025 Mar;14(3):e240204. doi: 10.57264/cer-2024-0204. Epub 2025 Jan 15.

Abstract

This study assessed the economic impact of reducing one postoperative visit following inflatable penile prosthesis (IPP) implantation. Scenario analyses were used to model the effects of eliminating one 30-min IPP postoperative visit from the expected 2.5 visits accounted for by the American Medical Association resource-based relative value scale data. The reduction was attributed to simplified teaching with a modified device. The recaptured time was applied to: the most frequent in-office CPT codes utilized by IPP implanters; evaluation and management of new ED patients pursuing/receiving IPPs; and in-office vasectomy. Physician work time and reimbursement were conservatively estimated using the 2024 Medicare Physician Fee Schedule and an alternative scenario where Advanced Practice Providers conducted IPP teaching was also modeled. Annually, reducing one 30-min IPP postoperative visit for practices performing 25/50/100 IPP implants recaptured 750/1500/3000 min, respectively. This recaptured time translates into as much as $18,325 additional annual Medicare reimbursement. At 25 implants yearly, urologists could help an additional 13-25 patients with office visits and observe an additional $2049-$2270 reimbursement. At 50 implants yearly, office evaluation and counseling for 7 ED patients who progress to IPP implantation results in an additional $4125 reimbursement, excluding any diagnostic procedures and/or downstream surgical cases. At 100 implants yearly, recaptured schedule capacity can facilitate 37 in-office vasectomies, which translates to a $12,563 reimbursement. Achieving fewer IPP postoperative visits can optimize postoperative care and open schedule capacity that improves access to care for patients with urological needs.

摘要

本研究评估了减少阴茎充气式假体(IPP)植入术后一次随访的经济影响。采用情景分析方法,根据美国医学协会基于资源的相对价值量表数据,对从预期的2.5次术后随访中取消一次30分钟的IPP术后随访的效果进行建模。这种减少归因于使用改良装置进行简化教学。节省下来的时间用于:IPP植入医生最常使用的门诊现行程序编码(CPT);对寻求/接受IPP的急诊新患者的评估和管理;以及门诊输精管切除术。使用2024年医疗保险医生费用表保守估计医生的工作时间和报销情况,并对高级实践提供者进行IPP教学的替代情景进行建模。对于每年进行25/50/100例IPP植入手术的医疗机构,每年减少一次30分钟的IPP术后随访,分别可节省750/1500/3000分钟。这些节省下来的时间转化为每年高达18,325美元的额外医疗保险报销。每年进行25例植入手术时,泌尿科医生可以额外帮助13 - 25名患者进行门诊就诊,并获得额外2049 - 2270美元的报销。每年进行50例植入手术时,对7名进展为IPP植入的急诊患者进行门诊评估和咨询可额外获得4125美元的报销,不包括任何诊断程序和/或下游手术病例。每年进行100例植入手术时,节省下来的日程安排能力可促成37例门诊输精管切除术,这相当于12,563美元的报销。减少IPP术后随访次数可以优化术后护理,并腾出日程安排能力,从而改善对有泌尿系统需求患者的医疗服务可及性。

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