ABSTRACT
Objetivo: Analisar os custos das internações de pacientes com traumas ortopédicos internados em um hospital de referência. Métodos: Estudo quantitativo analítico. A pesquisa teve amostra de 200 prontuários. Foram utilizados testes de Mann-Whitney e Kruskal-Wallis e correlação de Spearman para a comparação dos valores médios das Autorizações de Internação Hospitalar (AIHs) e as características sociodemográficas e clínicas; significância de 5% e confiança de 95%. Resultados: Em relação aos resultados obtidos do valor médio das AIHs, segundo as características sociodemográficas e clínica, o sexo de maior custo foi o feminino (1.673,2) (p = 0,0016), com lesão localizada no quadril (1.973,8) (p = 0,0002), na parte anatômica do fêmur (2.595,3) (p = 0,0001). Houve destaque para a prevalência de pacientes com possíveis sequelas (1.924,2) (p = 0,0185) e óbito (3.919,4) (p = 0,1015). Conclusão: No estudo, foi identificado que os maiores custos de internações foram relacionados a pacientes do sexo feminino, com lesões em fêmur, tendo como etiologia a queda; ademais, fraturas expostas e localizadas na região do quadril possuem custos elevados. Possíveis sequelas e óbitos também têm valores maiores em relação aos custos das AIHs.
Objective: To analyze the costs of hospitalizations of patients with orthopedic trauma admitted to a referral hospital. Methods: Analytical quantitative study. The research had a sample of 200 medical records. The Mann-Whitney, Kruskal-Wallis and Spearman correlation tests were used to compare the mean values of Hospital Admission Authorizations (HAAs) and the sociodemographic and clinical characteristics; 5% significance and 95% confidence. Results: The results obtained from the average value of HAAs according to sociodemographic and clinical characteristics, the sex with the highest cost was female (1,673.2) (p = 0.0016), with location in the hip (1,973.8) (p = 0.0002 ), in the anatomical part of the femur (2,595.3) (p = 0.0001). The prevalence of patients with possible sequelae (1,924.2) (p = 0.0185) and death (3,919.4) (p = 0.1015) was highlighted. Conclusion: In the study, it was identified that the highest costs of hospitalizations were female patients, with injuries to the femur and whose etiology was the fall; in addition, open fractures located in the hip region have high costs. Possible sequelae and deaths also have higher values in relation to the costs of HAAs.
Subject(s)
Wounds and Injuries , Epidemiology , Costs and Cost Analysis , Fractures, BoneABSTRACT
OBJECTIVES@#Implants for traumatic orthopedic injuries are costly, and usually borne by the patient. We determined whether a consignment policy decreases morbidity and mortality rates, decreases length of stay, and decreases total expenditure of our patients.@*METHODS@#This is an ambispective cohort study comparing patients whose orthopedic implant surgeries were done before consignment policy and thus paid for out-of-pocket (Group A), and patients whose surgeries were done under the policy, and whose implants were paid for by hospital funding (Group B). Patient records and hospital bills were reviewed. A total of 206 patients were included in the study, and we gathered data from department and hospital records regarding the incidence of morbidity, mortality, length of stay, and total hospital expenditure.@*RESULTS@#In this study, we demonstrate no difference in the incidence of morbidities and mortalities between the two groups. There was also no significant difference in the total hospital expenditure of both. There is a slightly shorter preoperative stay, and significantly longer postoperative and total hospital stays for Group B patients.@*CONCLUSION@#The consignment policy, in its first year of implementation, demonstrated no difference in the incidence of morbidity and mortality, or total hospital expenditures. Further long-term studies may be undertaken to improve accuracy of results.
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Objective:To evaluate the effectiveness of perioperative fasting abbreviation in traumatic patients with orthopaedic trauma and diabetes mellitus undergoing selective surgery.Methods:The patients were selected for this prospective nonrandomized controlled study who had undergone selective surgery from June 2019 to June 2021 at Department of Orthopaedic Trauma, Beijing Jishuitan Hospital. They were divided into an intervention group and a control group according to the wards where they stayed. The intervention group was fasted for solids from 0 o'clock on the surgery day and received oral solution with 6.25% maltodextrin which had been prepared by the nutritional department 3 hours prior to surgery. The control group was fasted for either liquids or solids from the midnight before surgery. All patients were evaluated according to the wake-up score and defensive reflex score after surgery. Once they were awakened, they were allowed slag-free drinks. Normal food was allowed if there was no discomfort after 2 hours. The 2 groups were compared in terms of basic information, actual preoperative fasting time, total amount of preoperative drinking, and postoperative time for initial drinking and eating. The perioperative subjective feelings (anxiety, thirst, hunger, nausea, fatigue, dizziness, sweating, stomach discomfort, etc.), grip strength and blood glucose were observed and compared between the 2 groups. Adverse reactions in the 2 groups were also observed.Results:A total of 135 patients were included, including 52 in the intervention group and 83 in the control group. The intervention group consisted of 22 males and 30 females aged from 30 to 84 years; the control group consisted of 39 males and 44 females aged from 29 to 81 years. There was no significant difference in the basic information between the 2 groups, showing comparability ( P>0.05). The intervention group had significantly shorter preoperative fasting time [3.5 (2.5, 6.3) h versus 12.0 (9.0, 16.0) h], significantly higher water intake before surgery [300 (200, 300) mL versus 100 (100, 200) mL], significantly shorter postoperative fasting time [0.08 (0, 1.25) h versus 2.00(0, 6.00) h], and significantly reduced time to return to normal diet [2.0 (2.0, 2.3) h versus 3.0(2.0, 6.0) h] than the control group (all P<0.05). The symptoms of anxiety, fatigue, sweating, and stomach discomfort in the intervention group were significantly fewer than those in the control group throughout the evaluation period. The thirst in the intervention group was significantly alleviated than that in the control group immediately after returning to the ward after surgery, and the dizziness and hunger were significantly alleviated than those in the control group when the patients left the ward to the operation room before surgery and immediately after returning to the ward. The symptom of nausea after returning to normal diet in the intervention group was significantly relieved compared with the control group. All the comparisons above showed statistically significant differences ( P<0.05). The blood glucose in the intervention group 2 hours after taking slag-free drinks was significantly higher than that in the control group ( Z=-2.108, P=0.035). There was no significant difference in the blood glucose between the 2 groups during other measurement periods ( P>0.05). There were no serious adverse reactions in either of the 2 groups. Conclusion:The protocol of perioperative fasting abbreviation may be safe and feasible for the patients with orthopaedic trauma and diabetes mellitus undergoing selective surgery, because it shows benefits of improving the patients' subjective feelings and stabilizing the blood glucose perioperatively.
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The practice of daily case discussion in the morning using slice show has been cartied out since orthopedic trauma department of Nanfang Hospital was set up.Bilingual ( Chinese and Englisl) discussion was hold in the department before and after the operation on the cases requiring three-level or higher level operation and those of special diseases.The bilingual case discussions will greatly improve the clinical thinking and accumulate the clinical experiences for doctors.The professional English proficiency of all doctors in the department have been improved because of the bilingual case discussions and the most effective treatment for patients was provided at the same time.
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Objective To discuss the influence of all- inclusive nursing for patients with orthopedic trauma on the aspects of their body and mind. Methods According to the related reference, made out allinclusive nursing ideas, and then used in 100 patients with orthopedic trauma (intervention group), routine rehabilitation was used in the control group (100 cases with orthopedic trauma). Compared the somatopsychic codition and the rehabilitation between the two groups. Results The 6 indexes of rehabilitation in the intervention group were significant better than those of in the control group. Somatopsychic condition in the intervention group was satisfactory. Conclusions All-inclusive nursing should be promoted in chnic by its merits.