| Summary: | 碩士 === 國立中山大學 === 醫務管理研究所 === 99 === Hysterectomy is the second highest frequency of gynecologic surgery. With limited medical resources, understanding of qualities and expenses of different types of surgery can be used as a reference for patients and hospital administrators in making related decisions.
Therefore, the purpose of this study is to compare the outcomes between “Total Abdominal Hysterectomy” and “Laparoscopic Hysterectomy”. Data sources are the health insurance report data files and charts of a regional teaching hospital. There were 114 cases between January 2006 and June 2010 at the sample hospital. Operating time, length of stay, and intra-operative blood loss between both types of hysterectomy are analyzed and compared by using t-test. Linear regression analysis is then used to examine the predictive factors that impact the outcomes of both types of surgery.
The results indicate that, in terms of clinical results, laparoscopic hysterectomy takes 120.45 minutes on average, and total abdominal hysterectomy 104.35 minutes; laparoscopic hysterectomy requires an average of 4.73 days of hospital stay, and total abdominal hysterectomy 5.54 days; and finally, laparoscopic hysterectomy causes an average of intra-operative blood loss of 249.70cc, and total abdominal hysterectomy 290.21cc, laparoscopic hysterectomy costs an average of NT$69,268.85, and total abdominal hysterectomy NT$46,634.88. In regard to hospitalization costs, laparoscopic hysterectomy costs an average of NT$49,732.50, and total abdominal hysterectomy costs NT$42,066.27.
Based on findings of this study, the following suggestions are proposed: (1) Laparoscopic hysterectomy can be safely and effectively used for patients with large uterine myoma or multiple myoma. (2)Hospitals should develop standardized medical treatment procedures; therefore, cost control would not be at the expense of the quality of care. Furthermore, standardization of medical treatment can be used to pinpoint whether there is any waste in the medical treatment process.
Keywords: uterine myoma, hysterectomy, total abdominal hysterectomy, laparoscopic hysterectomy, outcome.
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