Sills E S, Saini J, Applegate M S, McGee M, Gretz H F
Center for Reproductive Medicine and Infertility, New York Hospital-Cornell Medical Center, New York, USA.
J Urban Health. 1998 Dec;75(4):903-10. doi: 10.1007/BF02344519.
To describe practice trends for total abdominal hysterectomy (TAH) and supracervical abdominal hysterectomy (SCH) in New York State and to identify fiscal features associated with these two operations, all inpatient discharges for TAH and SCH performed for benign indications from 1990 to 1996 were reviewed using the Statewide Planning and Resource Cooperative System, a centralized data reporting system. For each year examined, the number of TAHs and SCHs performed, the procedure rates adjusted for the total New York State female population, and the per diem charge (calculated from mean institutional charge as a function of average length of stay) were evaluated. While the TAH rate declined in New York State, from 34.0 in 1990 to 28.4 in 1996 (P = .01), the SCH rate increased nearly five-fold during the same period, from 0.62 to 3.07 (P = .0003). Patients tended to be discharged later following SCH than for TAH, although by 1996, the LOS for both operations was equivalent. The per diem institutional charge for SCH was consistently higher than for TAH in each year studied. The changes in charge and relative frequency of TAH and SCH in New York State invite further study to describe these trends more fully.
为描述纽约州全腹子宫切除术(TAH)和次全腹子宫切除术(SCH)的手术趋势,并确定与这两种手术相关的财务特征,我们使用全州规划与资源合作系统(一个集中的数据报告系统)对1990年至1996年因良性指征进行TAH和SCH的所有住院出院病例进行了回顾。对于所研究的每一年,评估了TAH和SCH的手术数量、根据纽约州女性总人口调整后的手术率以及每日费用(根据平均住院时间的机构平均费用计算)。虽然纽约州的TAH率有所下降,从1990年的34.0降至1996年的28.4(P = 0.01),但同期SCH率增长了近五倍,从0.62增至3.07(P = 0.0003)。与TAH相比,接受SCH手术的患者出院时间往往较晚,不过到1996年,两种手术的住院时间相同。在研究的每一年中,SCH的每日机构费用一直高于TAH。纽约州TAH和SCH的费用及相对频率变化值得进一步研究,以便更全面地描述这些趋势。