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JAMA Surg：腹腔镜手术去哪？大型综合医疗机构vs一般医疗机构

2017-07-07 zhangfan MedSci原创

腹腔镜手术并发症ICU
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研究表明在高星级的大型综合医疗机构进行腹腔镜手术的质量与低星级的一般医疗机构差异不显著，但高星级医院对于医疗资源的利用以及花费的控制更为合理

医疗以及医疗保险中心(CMS)近日公布了医院整体质量星级排名以帮助患者进行医院的选择。该星级评价医疗机构的总体质量但对具体手术质量效果的评估尚不清楚。为此研究人员考察了CMS医院星级对 腹腔镜手术质量的影响。研究从2013年1月1日至2015年12月31日，研究比较了72662例腹腔镜腹部手术的结果，其中高星级医院(HSHs)定义为4-5星，低星级医院(LSHs)定义为1-2星。该星级评估包括7个领域的57个具体措施质量。患者接受的腹腔镜手术包括减肥手术（胃袖状切除术、胃旁路术），结直肠手术（结肠、直肠切除术）、食管裂孔疝手术（食管裂孔疝修补，Nissen胃底折叠）。风险调整排除极端严重疾病患者。主要终点是严重并发症率、死亡率、ICU接诊和医疗成本。66个高星级医院(患者38299人，平均年龄51.26岁，31.5%为男性，75.6%为白人)和78个低星级医院(患者34363； 平均年龄49.77岁 28.8%为男性，67.6%)进行73662例腹腔镜腹部手术。其中高星级医院ICU接诊人数减少 (1007起[2.6%] vs 1711起 [5.0%]， P<0.001) 而且医疗

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    2017-07-09 xinxin088

    #腹腔镜#

    0

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    2017-07-09 cy0324

    #医疗机构#

    0

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    2017-07-09 longqijun252

    #腹腔镜手术#

    0

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    2017-07-07 130****4638

    学习了受益匪浅

    0

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    2017-07-07 189****7206

    学习了谢谢分享

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    2017-07-07 楠博One

    到基层开展

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    2017-07-07 圣艮山

    学习了不少事情！

    0

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