Optimization of Health Expenditure in Major Surgery: Impact of a Mixed, Clinical and Ethnographic Approach in the Model of Liver Surgery
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 3,000
- 试验地点
- 11
- 主要终点
- overall postoperative length of stay
研究概览
简要总结
The aim of this study is to reduce the length of stay after liver surgery by taking account of objective quantitative clinical variables, subjective qualitative clinical variables and non clinical variables.
详细描述
a new dimension of the activity expected of physicians is to improve the safety of care on the one hand and the control of health care costs on the other.
key measures to help them are the publication of national recommendations, assessment of actual practices and the incentive to activity.
Internationalwide recent and concordant data suggest that
- quality and security of care, after an initial improvement, are going to stall
- scientific recommendations are rarely validated by an impact analysis and are not applied
- clinical data collected within an administrative framework are unreliable and too generalist
- the evaluation, especially in the surgical field, is based on indicators sometimes irrelevant and often unclear
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •elective liver surgery
- •older than 18
- •agreed to participate
- •surgical procedure included procedures registered as "HLFA003 - 007 ; 009 - 011 ; 017 - 020 ; HLFC002 à 004 ; 027 ; 032 ; 037" in the PMSI database
排除标准
- •emergency surgery
- •refused to participate
研究组 & 干预措施
operated patients
this cohort includes patients who underwent a liver surgery whatever the pathology and whatever the surgical procedure
干预措施: liver surgery (Procedure)
结局指标
主要结局
overall postoperative length of stay
时间窗: during the 3 months after the surgery
the overall postoperative length of stay is defined as the hospitalization between the surgery and patient's discharge. This period includes the readmission for at least 24 hours in case of outcomes related to the surgery.
次要结局
- peroperative outcomes(during the surgical procedure)
- construct of pronostic models(after the postoperative month 3)
- evaluation of PMSI indicators(after the postoperative month 3)
- postoperative outcomes(after the surgery until postoperative month 3)