摘要
目的 探讨乳腺良性肿瘤手术治疗模式的实施效果,评估日间手术的安全性、效率和控费效果,推进日间手术高质量发展。方法 收集2019年1月1日—2022年12月31日浙江大学医学院附属第二医院乳腺良性肿瘤手术患者病案首页数据,通过倾向性匹配消除混杂因素,分析日间手术对乳腺良性肿瘤患者的医疗质量、医疗效率和医疗费用的影响。将研究对象分为日间手术组和常规手术组。运用普通最小二乘法(ordinary least squares, OLS)回归模型,分析日间手术对医疗费用和医疗效率的影响;运用logit和probit模型,分析日间手术对医疗质量的影响。结果 匹配后协变量在日间手术组与常规手术组之间的分布达到较好均衡。共获得868例有效样本,与常规手术患者相比,日间手术患者的医疗费用低34.54%,但耗材费用高13.1%,人均住院天数缩短1.4 d,治愈情况更优。结论 乳腺良性肿物日间手术能够显著降低医疗费用、缩短住院天数,提高治愈效果,但是增加了耗材费用。为促进日间手术的高质量发展,需多渠道精准控费、加强日间手术术后回访、采取精细化日间手术康复协作模式。
Objective To evaluate the effect of the surgical treatment model for benign breast tumors,particularly in terms of the safety,efficiency and cost-control of day surgery,and to promote its high-quality development.Methods Medical record front-page data of patients who underwent surgery for benign breast tumors in the Second Affiliated Hospital of Zhejiang University School of Medicine from January 1,2019 to December 31,2022 were collected.Propensity score matching was used to eliminate confounding factors and to assess the impact of day surgery on medical quality,efficiency and cost.Patients were divided into day surgery and conventional surgery groups.Ordinary least squares(OLS)regression was used to examine the impact of day surgery on medical expenses and efficiency,while logit and probit models were applied to analyze its impact on medical quality.Results After matching,the distribution of covariates between the day surgery and the conventional surgery groups achieved a good balance.A total of 868 valid cases were included.Compared with conventional surgery patients,those undergoing day surgery had 34.54%lower total medical cost,13.1%higher consumable cost,a 1.4 days reduction in average hospital stay,and better clinical outcomes.Conclusions Day surgery for benign breast tumors significantly reduces medical costs,shortens hospital stays,and improves treatment outcomes,although it increases consumable costs.In order to promote the high-quality development of day surgery,it is essential to implement precise cost-control strategies,enhance postoperative follow-up,and adopt a refined collaborative rehabilitation model.
作者
廖藏宜
王桂松
林敏
LIAO Zangyi;WANG Guisong;LIN Min(School of Political Science and Public Administration,China University of Political Science and Law,Beijing 100088,China;The Second Affiliated Hospital Zhejiang University School of Medicine,Hangzhou 310009,Zhejiang,China)
出处
《健康发展与政策研究》
北大核心
2025年第4期457-463,共7页
Health Development and Policy Research
