Gibbs B F, Guzzetta V J, Furmanski D
Sharp Hospital System, San Diego, Calif., USA.
Ann Vasc Surg. 1995 Sep;9(5):423-7. doi: 10.1007/BF02143853.
The purpose of this study was to compare hospital charges for carotid endarterectomy on a surgeon-specific basis. The cost of carotid endarterectomy is influenced by preoperative evaluation, operating time, use of the intensive care unit, length of hospital stay, and surgical results. Length of stay and average hospital charges for 18 doctors performing 344 carotid endarterectomies at three hospitals were analyzed. Outcome data were also reviewed. The results demonstrated a wide variation in hospital charges among surgeons. Surgeons using the most cost-effective measures achieved comparable or superior outcomes. In an era of managed care, severe cost constraints mandate that surgeons perform similar studies in their own communities so that cost-effective clinical pathways can be developed. With the use of appropriate guidelines, carotid endarterectomy can be performed at relatively low cost without sacrificing quality.
本研究的目的是在外科医生个体的基础上比较颈动脉内膜切除术的医院收费情况。颈动脉内膜切除术的费用受术前评估、手术时间、重症监护病房的使用、住院时间和手术结果的影响。分析了在三家医院为344例患者实施颈动脉内膜切除术的18位医生的住院时间和平均医院收费情况。还对结果数据进行了审查。结果表明，不同外科医生的医院收费存在很大差异。采用最具成本效益措施的外科医生取得了相当或更好的结果。在管理式医疗时代，严格的成本限制要求外科医生在自己所在社区开展类似研究，以便制定出具有成本效益的临床路径。通过使用适当的指导方针，在不牺牲质量的前提下，可以以相对较低的成本实施颈动脉内膜切除术。
