| Summary: | 碩士 === 國立成功大學 === 高階管理碩士在職專班 === 97 === Medical care has entered a new era of providing the highest service quality with the lowest cost. However, most of the recent studies are focusing on either about costing analysis or service quality of healthcare. It is necessary to consider a model combing costing methodology with patient satisfaction measurement in order to compare the performance of endoscopic decompressive surgery with open decompressive surgery for patients with carpal tunnel syndrome (CTS).
CTS is the most common entrapment neuropathy. Surgical release of the flexor retinaculum is indicated in order to decompress the carpal tunnel. A healthcare costing model and the patient evaluation measure (PEM) questionnaire, which were developed in the previous literature, is used to investigate CTS patients from October 2008 to June 2009. A total of 162 questionnaires (82 open and 80 endoscopic surgery) were collected by neurosurgeon and orthopedic surgeon in a regional hospital postoperatively. Treatment costs were estimated from the database in the case hospital. Based on the statistical analysis, it is found out that the endoscopic surgery is significantly more costly than open surgery during acute stage (p=0.000), healing stage (p=0.000) and recovery stage (p=0.000), where the former one also has significantly higher PEM Score, which means a lower level of patient satisfaction, with the later one surgery at the recovery stage (p=0.041).
This study concludes that combination costing with patient satisfaction measurement is feasible and important to be used to compare different treatments. Furthermore, open surgery is superior to endoscopic decompressive surgery considering the cost factor and patient satisfaction. Besides CTS surgery, it is also suggested that other kinds of surgery should also apply proposed approach to satisfy customers effectively.
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