乳腺良性肿瘤实施日间手术的成本效果分析

The Cost-effect analysis on the ambulatory surgery for benign breast tumor

[目的]通过回顾性分析,对乳腺良性肿瘤实施日间手术与住院手术进行成本效果分析,为合理选择治疗方案提供依据。[方法]选择2014年2月-2016年6月于山西医科大学第二医院治疗的173名乳腺良性肿瘤患者,将采用日间手术的82名患者纳入日间组,同期在普通病房进行乳腺良性肿瘤手术的91名患者作为对照组。比较两组患者的平均住院费用、药费、耗材费、住院天数、手术效果、患者满意度,并对其进行成本效果分析。[结果]日间组平均住院费用、药费、耗材费、住院天数明显低于对照组,两组差异有统计学意义(P<0.001);日间组有效率为98.78%,对照组为93.41%;日间组患者满意度高于对照组(P<0.001);日间组成本效果比为4402.77,低于对照组的7387.03;以对照组为基础,增量成本效果比为-22640.61。[结论]乳腺良性肿瘤日间手术组与非日间手术组相比,日间手术在提高床位周转率、医疗资源的利用率及大幅度降低住院费用方面具有明显的优势。

Objective Through the method of retrospective analysis,the paper conduct the cost-effect analysis on the ambulatory surgery and the inpatient surgery for benign breast tumor so as to provide reference for later therapy. Methods 173 benign breast tumor patients,treated in the Second Hospital of Shanxi Medical University from Feb. 2014 to Jun. 2016,were chosen in this research. The paper took 82 cases who received ambulatory surgery in ambulatory group,and 91 inpatients who received breast tumor surgery in control group. The paper compared average hospitalization expense,consumable fee,hospitalization duration,therapy effect,patient satisfaction and cost-effect between the two groups. Results The average hospitalization expense,consumable fee,hospitalization duration,and patient satisfaction of the ambulatory group was significantly lower than control group s. There was statistical significance in the difference of two groups（ P 〈0.001）. Efficient of ambulatory group was 98.78%,control group was 93.41%. The satisfaction of ambulatory group was higher than control group s. The cost-effect ratio of ambulatory group was 4402.77,which was lower than that of control group（7387.03）. Effect ratio of incremental cost was -22 640.61 based on control group. Conclusions Compared with control group,ambulatory group has obvious advantages in improving the bed turnover ratio and medical resource utilization,and substantially reduce hospitalization expense.