The study of medical resource utilization and clinical outcome for Da Vinci robotic-assisted cholecystectomy

• Main Authors: Yu-Pei Li, 李育珮
• Other Authors: King-Teh Lee
• Format: Others
• Language: zh-TW
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/19970232911895629460

碩士 === 高雄醫學大學 === 醫務管理暨醫療資訊學系碩士在職專班 === 104 === Background/hypothesis Laparoscopic cholecystectomy (LC) is one of the most common procedures in general surgery and currently the standard of care for gallstone disease. Robotic cholecystectomy (RC) has revolutionized the field of minimally invasive surgery. Robotic surgery is safe and ergonomics but expensive. The aim of this study is to compare the medical resource utilization and clinical outcomes between the two procedures .The hypothesis is that robotic surgery will bring people good quality of surgical treatment and save the medical resource utilization. Methods and materials This is a retrospective study of database from a medical center in Southern Taiwan. In December 2015 made human trials / Research Project Case consent (IRB No.: KMUHIRB-E (I) -20160008). the study assessing data of the clinical outcomes and medical resource utilization of 58 patient receiving RC and 367 patients receiving LC from HIS database in this hospital from Aug,1, 2013 to Dec, 31, 2015 .We reviewed the data of operation time, length of stay , hospital charge ,OPD visits, OPD service charge and postoperative complication rate. The data were examined by student t test or Fisher’s exact test. Multivariate regression analysis was also done. Results Patients in both groups had similar demographic features and disease diagnosis in this study. The RC group had longer operation time (122.98±73.25 min vs.64.37±30.61, p<.001), and longer length of stay (5.21±5.54 day vs.3.73±1.77, p=.046), fewer OPD visits (p=.140) and OPD service charge (p=.606). The RC group, however, experienced less postoperative complication rate (3.4% vs. 20.4%, p=.002). Multivariate regression analysis demonstrated that RC was predicted to have longer operation time (p<.001) and longer hospital stay (p=.001), while the complication rate was predicted 6 times higher in LC group (OR=0.15 for RC, p=.014). The patients in RC group have to USD 5,000 in addition to the general hospital charge. Conclusion The RC group consumed more medical utilization; however, they experienced less postoperative complications.