Application of a selective hospitalization model in the clinical practice of breast surgery

选择性住院模式在乳腺外科临床实践中的应用

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Abstract

This study aimed to explore the clinical application of a selective hospitalization model in breast disease specialties and to evaluate its effectiveness. Information of patients registered in the selective hospitalization model and those registered in the direct model between October 1, 2020, and October 31, 2022, were collected. The hospitalization days and expenses of patients admitted through distinct modes and divergent medical categories were examined. After completing relevant examinations during the selected hospitalization period, 708 patients were admitted to our medical group for further treatment during the study period. Furthermore, 401 patients underwent hospitalization procedures immediately after the initial visit and received additional treatment after completing pertinent examinations during hospitalization. For patients who underwent benign surgery after admission, there was a significant difference in the length of hospital stay between patients admitted through selective hospitalization and those admitted directly (P < .001); however, there was no significant difference in total hospital expenses (P = .895). For patients who underwent malignant surgery after admission, there were significant differences in the length of hospital stay (P < .001) and total cost of hospitalization (P = .015). There was no significant difference in the length of hospital stay between the 2 groups of patients initially admitted for neoadjuvant chemotherapy (P = .589); however, the total cost of hospitalization significantly differed (P < .001). The selective hospitalization model can reduce medical expenses and the average length of hospital stay. This new hospitalization model is more flexible and allows for the inclusion of outpatient examination costs in subsequent hospitalization medical insurance reimbursement, greatly reducing the financial burden on patients. It is worthy of further exploration, optimization, and promotion.

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