PDF(Pubmed)
Abstract：
UNASSIGNED: To examine possible associations in inpatient healthcare expenditure and guideline changes in the surgical management of diverticulitis, in terms of both cost per discharge and total aggregate costs of care.
UNASSIGNED: Medical costs throughout the healthcare system continue to rise due to increased prices for services, increased quantities of high-priced technologies, and an increase in the amount of overall services.
UNASSIGNED: We used a retrospective case-control design using the Healthcare Cost and Utilization Project National Inpatient Sample to evaluate cost per discharge and total aggregate costs of diverticulitis management between 2004 and 2015. The year 2010 was selected as the transition between the pre and postguideline implementation period.
UNASSIGNED: The sample consisted of 450,122 unweighted (2,227,765 weighted) inpatient discharges for diverticulitis. Before the implementation period, inpatient costs per discharge increased 1.13% in 2015 dollars (95% confidence intervals [CI] 0.76% to 1.49%) per quarter. In the postimplementation period, the costs per discharge decreased 0.27% (95% CI -0.39% to -0.15%) per quarter. In aggregate, costs of care for diverticulitis increased 0.61% (95% CI 0.28% to 0.95%) per quarter prior to the guideline change, and decreased 0.52% (95% CI -0.87% to -0.17) following the guideline change.
UNASSIGNED: This is the first study to investigate any associations between evidence-based guidelines meant to decrease surgical utilization and inpatient healthcare costs. Decreased inpatient costs of diverticulitis management may be associated with guideline changes to reduce surgical intervention for diverticulitis, both in regards to cost per discharge and aggregate costs of care.
UNASSIGNED: Medical costs throughout the healthcare system continue to rise due to increased prices for services, increased quantities of high-priced technologies, and an increase in the amount of overall services.
UNASSIGNED: We used a retrospective case-control design using the Healthcare Cost and Utilization Project National Inpatient Sample to evaluate cost per discharge and total aggregate costs of diverticulitis management between 2004 and 2015. The year 2010 was selected as the transition between the pre and postguideline implementation period.
UNASSIGNED: The sample consisted of 450,122 unweighted (2,227,765 weighted) inpatient discharges for diverticulitis. Before the implementation period, inpatient costs per discharge increased 1.13% in 2015 dollars (95% confidence intervals [CI] 0.76% to 1.49%) per quarter. In the postimplementation period, the costs per discharge decreased 0.27% (95% CI -0.39% to -0.15%) per quarter. In aggregate, costs of care for diverticulitis increased 0.61% (95% CI 0.28% to 0.95%) per quarter prior to the guideline change, and decreased 0.52% (95% CI -0.87% to -0.17) following the guideline change.
UNASSIGNED: This is the first study to investigate any associations between evidence-based guidelines meant to decrease surgical utilization and inpatient healthcare costs. Decreased inpatient costs of diverticulitis management may be associated with guideline changes to reduce surgical intervention for diverticulitis, both in regards to cost per discharge and aggregate costs of care.
摘要：
■为了检查住院医疗支出和憩室炎手术管理指南变化之间可能的关联，在每次出院费用和护理总成本方面。
■由于服务价格上涨，整个医疗保健系统的医疗费用继续上涨，高价技术的数量增加，以及整体服务数量的增加。
■我们使用了回顾性病例对照设计，使用医疗保健成本和利用项目国家住院患者样本来评估2004年至2015年间憩室炎管理的每次出院成本和总成本。选择2010年作为指南执行前和指南执行后的过渡期。
■样本包括450,122例未加权（2,227,765加权）的憩室炎住院患者。在执行期之前，以2015年美元计算,每次出院的住院费用每季度增加1.13%(95%置信区间[CI]0.76%至1.49%).在充血后时期，每次排放成本每季度下降0.27%（95%CI-0.39%至-0.15%）。总的来说,在指南更改之前，憩室炎的护理费用每季度增加0.61%（95%CI0.28%至0.95％），并在指南变更后下降0.52%（95%CI-0.87%至-0.17）。
这是第一项调查旨在降低手术利用率的循证指南与住院医疗费用之间任何关联的研究。憩室炎治疗的住院费用降低可能与指南改变相关，以减少憩室炎的手术干预。在每次出院成本和护理总成本方面。
■由于服务价格上涨，整个医疗保健系统的医疗费用继续上涨，高价技术的数量增加，以及整体服务数量的增加。
■我们使用了回顾性病例对照设计，使用医疗保健成本和利用项目国家住院患者样本来评估2004年至2015年间憩室炎管理的每次出院成本和总成本。选择2010年作为指南执行前和指南执行后的过渡期。
■样本包括450,122例未加权（2,227,765加权）的憩室炎住院患者。在执行期之前，以2015年美元计算,每次出院的住院费用每季度增加1.13%(95%置信区间[CI]0.76%至1.49%).在充血后时期，每次排放成本每季度下降0.27%（95%CI-0.39%至-0.15%）。总的来说,在指南更改之前，憩室炎的护理费用每季度增加0.61%（95%CI0.28%至0.95％），并在指南变更后下降0.52%（95%CI-0.87%至-0.17）。
这是第一项调查旨在降低手术利用率的循证指南与住院医疗费用之间任何关联的研究。憩室炎治疗的住院费用降低可能与指南改变相关，以减少憩室炎的手术干预。在每次出院成本和护理总成本方面。
