Bakgrund: Ljumskbråck är den vanligaste operationen inom allmänkirurgin, varje år utförs nästan 20 000 operationer i Sverige. I Östergötland utförs ljumskbråcksoperationer på tre ställen inom ramen för dagkirurgi; vid Aleris Specialistvård i Motala (ASM), Närsjukvården i Finspång (NiF) samt Medicinskt Centrum i Linköping (MCL). Det finns en teori om att privata vårdgivare är mer tidseffektiva än offentliga vårdgivare. De privata anses kunna utföra fler operationer under en given tid, men ingen studie har gjorts på tidseffektiviteten kring operationerna hos respektive vårdgivare. Denna studie har genomförts för att detektera om det finns en skillnad i hur lång tid olika moment tar att utföra och vad denna skillnad i sådana fall beror på, samt om patientunderlaget skiljer sig mellan klinikerna. Metod: Studien omfattade 70 patienter fördelade på tre kliniker; ASM, MCL och NiF. Ljumskbråcksoperationerna delades upp i flertalet moment som mättes med digital klocka. Dessutom samlades uppgifter in om patientens ålder, ASA-klass, BMI samt information om vilka som närvarade i operationssalen. Statistisk analys gjordes enligt Kruskal-Wallis. Programvaran som användes var SPSS version 22. Resultat: Studien fann ingen signifikant skillnad i BMI, ASA-klass eller ålder mellan klinikernas patienter (p > 0,05 för samtliga). Däremot fanns stora skillnader vad gäller hur lång tid ett flertal av momenten under ljumskbråcksoperationen tog. Slutsats: Studien påvisar att det finns stora skillnader i olika moment vid ljumskbråcksoperationer. De privata klinikerna var alltid snabbare än den offentliga kliniken. Då det saknas studier inom området vore det intressant att se om det finns liknande skillnader vid andra ingrepp som utförs av olika aktörer. / Background: Inguinal hernia surgery is one of the most common surgeries within general surgery, with approximately 20 000 surgeries per year in Sweden. There are three places in Östergötland County where inguinal hernias are executed within outpatient surgery; at Aleris Specialistvård in Motala (ASM), Närsjukvården in Finspång (NiF) and at Medicinskt Centrum in Linköping (MCL). There is a theory that private health care providers are more time-efficient than public health care providers. The private health care providers are considered to perform more operations over a given time though no studies has been done on time efficiency. This study was performed to detect if there is a difference in time in the various steps during the surgery between the clinics, what causes these differences and if the patients differ. Methods: The study includes 70 patients distributed on three outpatient surgery clinics; ASM, MCL and NiF. The inguinal hernia operations were divided into shorter steps measured with a digital watch. Furthermore, data were noted about the patients’ age, ASA-score, BMI and who were present in the operating room. Statistical analyses were performed with the Kruskal-Wallis one-way analysis of variance. The software used was SPSS version 22. Results: The study found no significant difference in BMI, ASA-score and age between the health care providers (p > 0,05). However, regarding the time efficiency, there were significant differences between the clinics. Conclusions: The study concludes that there are big differences in time, within the various steps in the inguinal hernia surgeries, between the clinics. The private health care providers were always faster than the public health care provider. Since no earlier studies have been made in this area, it would be interesting to see if there are similar differences in other types of surgeries.
| Identifer | oai:union.ndltd.org:UPSALLA1/oai:DiVA.org:liu-122239 |
| Date | January 2015 |
| Creators | Karlsson, Louise, Olofsson, John |
| Publisher | Linköpings universitet, Hälsouniversitetets läkarutbildning, Linköpings universitet, Hälsouniversitetets läkarutbildning |
| Source Sets | DiVA Archive at Upsalla University |
| Language | Swedish |
| Detected Language | Swedish |
| Type | Student thesis, info:eu-repo/semantics/bachelorThesis, text |
| Format | application/pdf |
| Rights | info:eu-repo/semantics/openAccess |
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