지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.92 No.2
- 발행연도
- 2017.2
- 수록면
- 73 - 81 (9page)
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Purpose: Pancreaticoduodenectomy (PD) is a complex surgery associated with high morbidity, mortality, and cost. Municipal hospitals have their important role in the public health and welfare system. The purpose of this study was to identify the feasibility as well as the cost-effectiveness of performing PD in a mid-volume municipal hospital based on 13 years of experience with PD.
Methods: From March 2003 to November 2015, 183 patients underwent PD at Seoul Metropolitan Government – Seoul National University Boramae Medical Center.. Retrospectively collected data were analyzed, with a particular focus on complications. Hospital costs were analyzed and compared with a national database, with patients divided into 2 groups on the basis of medical insurance status.
Results: The percentage of medical aid was significantly higher than the average in Korean hospitals. (19.1% vs. 5.8%, P = 0.002). Complications occurred in 88 patients (44.3%). Postoperative pancreatic fistula (POPF) occurred in 113 cases (61.7%), but the clinically relevant POPF was 24.6% (grade B: 23.5% and grade C: 1.1%). The median hospital stay after surgery was 20 days (range, 6–137 days). In-hospital mortality was 3.8% (n = 7), with pulmonary complications being the leading cause. During the study period, improvements were observed in POPF rate, operation time, and hospital stay. The mean total hospital cost was 13,819 United States dollar (USD) per patient, and the mean reimbursement from the National Health Insurance Service (NHIS) to health care providers was 10,341 USD (74.8%). The patient copayment portion of the NHIS payment was 5%.
Conclusion: Performing PD in a mid-volume municipal hospital is feasible, with comparable results and cost-effectiveness.
Methods: From March 2003 to November 2015, 183 patients underwent PD at Seoul Metropolitan Government – Seoul National University Boramae Medical Center.. Retrospectively collected data were analyzed, with a particular focus on complications. Hospital costs were analyzed and compared with a national database, with patients divided into 2 groups on the basis of medical insurance status.
Results: The percentage of medical aid was significantly higher than the average in Korean hospitals. (19.1% vs. 5.8%, P = 0.002). Complications occurred in 88 patients (44.3%). Postoperative pancreatic fistula (POPF) occurred in 113 cases (61.7%), but the clinically relevant POPF was 24.6% (grade B: 23.5% and grade C: 1.1%). The median hospital stay after surgery was 20 days (range, 6–137 days). In-hospital mortality was 3.8% (n = 7), with pulmonary complications being the leading cause. During the study period, improvements were observed in POPF rate, operation time, and hospital stay. The mean total hospital cost was 13,819 United States dollar (USD) per patient, and the mean reimbursement from the National Health Insurance Service (NHIS) to health care providers was 10,341 USD (74.8%). The patient copayment portion of the NHIS payment was 5%.
Conclusion: Performing PD in a mid-volume municipal hospital is feasible, with comparable results and cost-effectiveness.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (30)
참고문헌 신청
[학술지(정기간행물)] - Kim CG / 2012 / Impact of surgical volume on nationwide hospital mortality after pancreaticoduodenectomy / World J Gastroenterol 18 : 4175 ~ 4181
[학술지(정기간행물)] - Dindo D / 2004 / Classification of surgical complications : a new proposal with evaluation in a cohort of 6336 patients and results of a survey / Ann Surg 240 : 205 ~ 213
[학술지(정기간행물)] - Bassi C / 2005 / Postoperative pancreatic fistula : an international study group(ISGPF)definition / Surgery 138 : 8 ~ 13
[학술지(정기간행물)] - Wente MN / 2007 / Delayed gastric emptying(DGE)after pancreatic surgery : a suggested definition by the International Study Group of Pancreatic Surgery(ISGPS) / Surgery 142 : 761 ~ 768
[학술지(정기간행물)] - Moon HJ / 2003 / A result of surgical treatment for ductal adenocarcinoma of the head of the pancreas / Korean J Gastroenterol 42 : 156 ~ 163
[학술지(정기간행물)] - Dindo D / 2004 / Classification of surgical complications : a new proposal with evaluation in a cohort of 6336 patients and results of a survey / Ann Surg 240 : 205 ~ 213
[학술지(정기간행물)] - Bassi C / 2005 / Postoperative pancreatic fistula : an international study group(ISGPF)definition / Surgery 138 : 8 ~ 13
[학술지(정기간행물)] - Wente MN / 2007 / Delayed gastric emptying(DGE)after pancreatic surgery : a suggested definition by the International Study Group of Pancreatic Surgery(ISGPS) / Surgery 142 : 761 ~ 768
[학술지(정기간행물)] - Moon HJ / 2003 / A result of surgical treatment for ductal adenocarcinoma of the head of the pancreas / Korean J Gastroenterol 42 : 156 ~ 163
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UCI(KEPA) : I410-ECN-0101-2017-514-002372250