Way J C, Culham B A
Department of Surgery, Calgary District Hospital Group, Alta.
Can J Surg. 1996 Oct;39(5):379-83.
The objective of this study was to show that minor operative procedures done in a nonhospital setting can be provided more efficiently than those done in hospital and are agreeable to both patient and surgeon. A description of the facility, equipment required and types of procedures that can be performed provides a guide for other surgeons who may wish to establish an office surgical suite. The senior author's experience from 1993 to 1995 is described. Costs were compared on a procedure basis from financial data obtained from the practice and from a local 400-bed community hospital. Experience shows that patients are receptive to undergoing minor procedures outside the traditional hospital setting. An office surgical suite allows the surgeon greater flexibility in work scheduling, thereby improving productivity. The cost per case appears to be less in the office than in the hospital for the particular costs identified. The current method of funding minor surgical procedures provides an incentive to the surgeon to perform these procedures in hospital, because the individual practitioner is not responsible for any operating expenses. Thus, if costs are to be reduced and quality maintained, funding mechanisms must be reformed to allow less costly service to evolve.
本研究的目的是表明，在非医院环境中进行的小型手术操作比在医院进行的更高效，并且患者和外科医生都能接受。对设施、所需设备以及可执行的手术类型的描述，为其他可能希望建立门诊手术套房的外科医生提供了指导。文中描述了资深作者在1993年至1995年期间的经验。根据从诊所和当地一家拥有400张床位的社区医院获得的财务数据，按手术程序对成本进行了比较。经验表明，患者愿意在传统医院环境之外接受小型手术。门诊手术套房使外科医生在工作安排上有更大的灵活性，从而提高了工作效率。就所确定的特定成本而言，门诊手术的每例成本似乎低于医院。目前为小型外科手术提供资金的方式促使外科医生在医院进行这些手术，因为个体从业者无需承担任何手术费用。因此，如果要在保持质量的同时降低成本，就必须改革资金机制，以使成本更低的服务得以发展。
