Albert R K, Lewis S, Wood D, Benditt J O
Department of Medicine, University of Washington, Seattle, USA.
Chest. 1996 Oct;110(4):1068-71. doi: 10.1378/chest.110.4.1068.
To investigate the economics of lung volume reduction surgery.
Medical center and physician charges obtained from billing records.
Academic health center.
Twenty-three consecutive patients undergoing lung volume reduction surgery at a single institution who were discharged from the hospital prior to November 1, 1995.
Length of hospital stay, mortality, medical center charges and professional fees, and sponsor reimbursement.
Median hospital stay was 8.0 days and there were no deaths. The median charge was $26,669 (range, $20,032 to $75,561) of which 73% was for medical center services and 27% was for physician services. Fees for medical center rooms and operating suite time accounted for 71% of medical center charges. Charges by surgeons and anesthesiologists accounted for 77% of professional fees. Total charges were directly related to length of stay (r2 = 0.95). Median reimbursement for medical center services was $22,264 (114%; range, $13,333 to $123,362) and for physician services was $2,783 (34%; range, $2,597 to $11,265), resulting in a median total reimbursement that represented 94% of total charges. The median reimbursement-to-cost ratio was 1.22, compared with 1.05 for all medical services in fiscal year 1995.
These data must now be assessed relative to outcomes such as quality of life, patient function, and long-term survival to determine cost-effectiveness of lung volume reduction surgery.
研究肺减容手术的经济学情况。
从计费记录中获取医疗中心和医生收费情况。
学术健康中心。
1995年11月1日前在单一机构接受肺减容手术并出院的23例连续患者。
住院时间、死亡率、医疗中心收费和专业费用以及赞助商报销情况。
中位住院时间为8.0天，无死亡病例。中位收费为26,669美元（范围为20,032美元至75,561美元），其中73%用于医疗中心服务，27%用于医生服务。医疗中心病房和手术室使用时间的费用占医疗中心收费的71%。外科医生和麻醉医生的收费占专业费用的77%。总收费与住院时间直接相关（r2 = 0.95）。医疗中心服务的中位报销额为22,264美元（114%；范围为13,333美元至123,362美元），医生服务的中位报销额为2,783美元（34%；范围为2,597美元至11,265美元），导致中位总报销额占总收费的94%。中位报销成本比为1.22，而1995财年所有医疗服务的该比例为1.05。
现在必须将这些数据与生活质量、患者功能和长期生存等结果相关联进行评估，以确定肺减容手术的成本效益。
