Lü Kun 1 , WANG Yu 1 , JIN Xin 1 , SUN Yifan 2 , WEI Yi 3 , LIU Xing 3 , LIN Tao 3 , HE Dawei 4 , WEI Guanghui 4 , LIU Junhong 1
  • 1. Department of Ambulatory Surgery, Children’s Hospital of Chongqing Medical University, Chongqing 400014, P. R. China;
  • 2. Academy of Pediatrics, Chongqing Medical University, Chongqing 400014, P. R. China;
  • 3. Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing 400014, P. R. China;
  • 4. Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Chongqing 400014, P. R. China;
LIU Junhong, Email: knifeuro@163.com
Day surgery; Cryptorchidism; Pediatric surgery; Evaluation of health economics
10.7507/1002-0179.201910044
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Objective To evaluate the health economics indexes of day surgery mode and traditional specialist hospitalization mode, and to provide reference for the selection of different hospitalization mode of inguinal-type cryptorchidism in children.Methods The patients with unilateral cryptorchidism under 5 years old between January 2017 and January 2018 in Chongqing Children’s Hospital were selected in this study. According to different inpatient surgery modes, the included children were divided into day surgery group (day group) and special in-hospital surgery group (specialty group). The general data of patients, treatment indicators, incidence of complications, postoperative testicular atrophy rate, recurrence, nosocomial infection, hospitalization time, hospitalization cost, satisfaction of patients, and other health effect indicators between the two operation modes were compared. The treatment effect indexes and cost-effect ratio of the two modes were statistically analyzed.Results A total of 198 children were included, including 83 in the day group and 115 in the specialty group. The patients in both groups underwent orchiopexy by small inguinal dermatoglyph and scrotal incision. There was no statistically significant difference in the affected side, source area, postoperative complications, or nosocomial infection between the two groups (P>0.05). The patients in the specialty group were older than those in the day group [(27.60±11.04) vs. (20.88±9.48) months old; t=4.586, P<0.001]; the bed occupancy time [(118.60±10.80) vs. (23.95±5.90) h; t=72.353, P<0.001] and operation time [(0.45±0.15) vs. (0.38±0.12) h; t=2.946, P=0.004] in the specialty group were longer than those in the day group. The difference was statistically significant in hospitalization expenses between the two groups (χ2=155.374, P<0.001); 92.8% of the children in the day group spent less than 5 000 yuan, while 95.7% of the children in the specialty group spent more than 5 000 yuan. The American Society of Anesthesiologists scores in the specialty group were higher than those in the day group (χ2=44.870, P<0.001). The treatment effect indexes in the day group and the specialty group were 0.99 and 1.01, respectively, and the cost-effect ratios were 3 850 and 6 657, respectively. The economic benefit of the day group was better.Conclusions The cost-effectiveness of day surgery is better than that of specialized inpatient surgery. Therefore, this model can be recommended for children who meet the indications of day surgery.

Citation： Lü Kun, WANG Yu, JIN Xin, SUN Yifan, WEI Yi, LIU Xing, LIN Tao, HE Dawei, WEI Guanghui, LIU Junhong. Comparison of health economics evaluation between day surgery and special in-hospital surgery mode for the treatment of cryptorchidism in children. West China Medical Journal, 2020, 35(2): 170-175. doi: 10.7507/1002-0179.201910044 Copy

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