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Obstet Gynecol:子宫切除术成本是否存在地域差异?

2017-05-06 xing.T MedSci原创

由此可见,在调整混杂因素后,子宫切除术的成本因地理位置不同存在显著的差异。

近日,妇产科权威杂志Obstetrics and Gynecology上发表了一研究文章,研究人员旨在评估子宫切除的成本是否因地理位置不同而存在差异。

在这项以人口为基础的横断面研究中,研究人员采用了2013年医疗保健成本和使用项目全国住院病人样本中那些年龄超过18岁并住院接受了子宫切除术治疗良性疾病的妇女作为研究对象。从全国住院样本数据库获得的医院费用是通过医疗保健成本和使用项目提供的成本费用比率转换为实际成本。研究人员使用多变量回归来评估人口因素、合并手术操作、诊断和地理区域对高于中位数的子宫切除术成本的影响。

研究人员确定了因良性病变接受子宫切除的妇女(n=38414)。子宫切除术成本的中位数为13981美元(四分位间距为9075-29770美元)。大西洋中部地区的手术成本中位数最低为9661美元(四分位间距为6243-15335美元),太平洋地区的手术成本中位数最高,为22534美元(四分位间距为15380-33797美元)。与大西洋中部地区相比,太平洋(调整后的比值比[OR]为10.43,95%可信区间为[CI]9.44-11.45)、大西洋南部(调整后的OR为 5.39,95%CI为4.95-5.86)和中南部调整后的OR为2.40,95%CI为2.21-2.62)区域的手术成本高于中位数的概率最大。除双侧输卵管切除术外,所有合并手术均会增加手术的成本(调整后的OR为1.03,95%CI为0.95-1.12)。与阴式子宫切除术相比,腹腔镜和机器人下子宫切除术与较高的成本增加概率相关(分别有调整后的OR为2.86,95%CI为 2.61-3.15,调整后的OR为5.66,95%CI为5.11-6.26)。与阴式子宫切除术相比,腹部子宫切除术与成本增加无显著的相关性(调整后的OR为1.01,95%CI为0.91-1.09)。

由此可见,在调整混杂因素后,子宫切除术的成本因地理位置不同存在显著的差异。

原始出处:


Sheyn, David, et al. Geographic Variance of Cost Associated With Hysterectomy.Obstetrics & Gynecology.2017. http://journals.lww.com/greenjournal/Fulltext/2017/05000/Geographic_Variance_of_Cost_Associated_With.11.aspx

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style='color:#2F92EE;'>#子宫切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45166, encryptionId=3ea645166c7, topicName=子宫切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=医者仁心, createdTime=Mon May 08 10:19:00 CST 2017, time=2017-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195346, encodeId=ecef1953469f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161217/IMG585499DFC35A96490.jpg, createdBy=72381996390, createdName=1e1b8c04m38(暂无匿称), createdTime=Mon May 08 09:46:08 CST 2017, time=2017-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195314, encodeId=eaca19531414, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfDEeydJz0GlP8O0ngrUX6AYCXFic0XDOOAyeQicIqnOd4TrWSwiagJrsFNYuWC1Uc6iavbS1hWt9xtZAhAqLGHqZyl/0, createdBy=42891977006, createdName=1e17414fm02(暂无匿称), createdTime=Mon May 08 08:26:25 CST 2017, time=2017-05-08, status=1, ipAttribution=)]
    2017-07-02 仁医06
  5. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfDEeydJz0GlP8O0ngrUX6AYCXFic0XDOOAyeQicIqnOd4TrWSwiagJrsFNYuWC1Uc6iavbS1hWt9xtZAhAqLGHqZyl/0, createdBy=42891977006, createdName=1e17414fm02(暂无匿称), createdTime=Mon May 08 08:26:25 CST 2017, time=2017-05-08, status=1, ipAttribution=)]
    2017-05-09 lou.minghong

    应该是很普遍的

    0

  6. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfDEeydJz0GlP8O0ngrUX6AYCXFic0XDOOAyeQicIqnOd4TrWSwiagJrsFNYuWC1Uc6iavbS1hWt9xtZAhAqLGHqZyl/0, createdBy=42891977006, createdName=1e17414fm02(暂无匿称), createdTime=Mon May 08 08:26:25 CST 2017, time=2017-05-08, status=1, ipAttribution=)]
    2017-05-08 王国安

    学习了非本科的知识,也受益呀。

    0

  7. 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    2017-05-08 微笑人参

    夸科学习,都是知识

    0

  8. 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  9. 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    2017-05-08 1e1b8c04m38(暂无匿称)

    学习

    0

  10. 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    2017-05-08 1e17414fm02(暂无匿称)

    学习

    0

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Plast Reconstr Surg: 行子宫切除术时可联合美容外科手术一并切除“悬挂”在腹部的脂肪据最新的一项研究结果显示,子宫切除术联合脂膜切除术似乎并不常被采用,尽管此术式与单纯子宫切除术式仅存在住院时间长短的差异。该研究结果发表于《 Plastic and Reconstructive Surgery》,研究人员表示,女性在行子宫切除术时刻同时切除“悬挂”在腹部的脂肪及皮肤(称为脂膜切除

J Clin Endocrinol Metab:绝经后女性行子宫切除术可增加甲状腺癌的发病风险

已知雌激素是甲状腺癌发病的一个危险因素。本研究旨在子宫切除术、双侧输卵管卵巢切除术(BSO)与甲状腺癌发病率之间的关联。 采用前瞻性队列研究,纳入美国40个临床中心的127566名参与女性健康计划(1993-1998年)的研究对象,年龄在50-79岁。 主要研究结果为子宫切除术和BSO,使用医疗记录审查证实甲状腺癌病例。 结果,平均随访14.4年后,共发生了344例甲状腺癌病例。

JACC:中年女性行子宫切除术不增加心血管疾病风险

  与一些早期研究相反,一项新的美国研究发现中年女性进行子宫切除术(伴或不伴卵巢切除)后,罹患心血管疾病的风险并未上升。这些女性罹患心血管病的风险并不高于自然绝经的女性,该新研究说。   匹兹堡大学首席作家Karen A. Matthews及同事在一份报告中写下了他们的发现,这份报告计划于本周在线发布于《美国心脏病学会杂志》。   Matthews,匹兹堡的一位杰出的精神病

IJGO:小切口子宫切除术可行效果好

  美国学者的一项研究显示,小切口子宫切除术可用于切除非常大的子宫,且不需要特殊昂贵的设备或先进的内镜培训。而机器人辅助下腹腔镜子宫切除术,做得好的话则可以更早出院。相关论文于2013年5月13日在线发表于 《国际妇产科学杂志》(INT J GYNECOL OBSTET)   该研究回顾性分析了84例经过小切口子宫切除术(n=54)或机器人辅助腹腔镜手术(

AHJ:子宫切除术并不增加心脏病风险

  与一些早期研究相反,一项新的美国研究发现中年女性进行子宫切除术(伴或不伴卵巢切除)后,罹患心血管疾病的风险并未上升。这些女性罹患心血管病的风险并不高于自然绝经的女性,该新研究说。   匹兹堡大学首席作家Karen A. Matthews及同事在一份报告中写下了他们的发现,这份报告计划于本周在线发布于《美国心脏病学会杂志》。   Matthews,匹兹堡的一位杰出的精神病

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