Mannel R S, Manetta A, Hickman R L, Walker J L, Berman M L, DiSaia P J
Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City.
J Am Coll Surg. 1994 Nov;179(5):558-60.
Cost-containment issues are becoming increasingly important in medicine. The current study compares bedside versus operating room insertion of Hickman catheters from a cost and safety standpoint.
A prospective chart review of all patients undergoing Hickman catheter insertion during the study period was performed to determine location of the procedure, rate of successful catheter placement, complications, and cost.
Ninety-six patients underwent placement of 108 Hickman catheters during a seven year period. Fifty-three catheters were inserted at bedside while 55 catheters were placed in the operating room. The complication rate was 8 percent for the bedside and 9 percent for the operating room group. Due to anesthesia standby, operating room time, and fluoroscopy, cost analysis revealed a substantial savings of $1,545 per patient if bedside insertion was utilized.
The data indicate that, in select patients, percutaneous insertion of Hickman catheters at bedside is a safe, cost-effective procedure.
成本控制问题在医学领域正变得越来越重要。本研究从成本和安全性角度比较了在床边与手术室插入Hickman导管的情况。
对研究期间所有接受Hickman导管插入术的患者进行前瞻性图表回顾，以确定手术地点、导管成功置入率、并发症及成本。
在七年期间，96例患者置入了108根Hickman导管。53根导管在床边插入，55根导管在手术室置入。床边组的并发症发生率为8%，手术室组为9%。由于麻醉备用、手术室时间和荧光透视，成本分析显示，如果采用床边插入，每位患者可节省1545美元。
数据表明，在特定患者中，床边经皮插入Hickman导管是一种安全、经济有效的方法。
