Postma M J, Kornarou H, Paparizos V, Leidl R M, Tolley K, Kyriopoulos J, Jager J C
Groningen University Institute for Drug Exploration (GUIDE), GUIDE/SFF, The Netherlands.
Health Care Manag Sci. 2000 Jan;3(1):1-7. doi: 10.1023/a:1019064518010.
This paper compares AIDS hospital care in several European-Union countries. For this purpose hospital-care utilisation studies on inpatient days and outpatient contacts were analysed in a generic approach controlling for severity stages of AIDS. Lifetime hospital-care needs for AIDS are derived, providing useful information for health-care policy makers. In a next step, lifetime estimates are linked to estimated annual new cases of AIDS, resulting from standardised epidemiological modelling. These results on AIDS impact at the population level are reported including statistical confidence limits. Both lifetime hospital-care needs at the patient level and AIDS impact at the population level are compared between countries and related to characteristics of the national AIDS epidemics and health-care systems. A person with AIDS has a contact--either inpatient day or outpatient visit--with the hospital in 14% (UK) to 24% (France) of the days spent in the AIDS stage. Related to the national AIDS epidemics (epidemiological impact), Italy and Greece have high levels of outpatient contacts per million population. Estimated hospital-bed needs for AIDS in 1995 are up to 2.13% (in Spain) of total national acute-care hospital beds available. Estimated per-capita needs for outpatient visits in 1995 are highest in Italy, corresponding to 108 doctor full-time equivalents. In a case-study for Greece and The Netherlands, differences in hospital-care utilisation patterns were assessed to correspond with differences in their health-care systems (number of hospital beds, doctors and nurses per capita and some qualitative characteristics of medical care in both countries). International comparison of AIDS hospital care is possible using standardised analysis of national hospital-care utilisation data and standardised epidemiological modelling. Estimates of lifetime hospital-care needs are an essential input for cost-effectiveness analyses used to aid health-care policy decision-making.
本文比较了几个欧盟国家的艾滋病医院护理情况。为此，采用通用方法分析了住院天数和门诊接触的医院护理利用研究，同时控制艾滋病的严重程度阶段。得出了艾滋病患者一生的医院护理需求，为医疗保健政策制定者提供了有用信息。下一步，将一生的估计需求与标准化流行病学模型得出的艾滋病估计年度新病例数联系起来。报告了这些关于艾滋病对人群影响的结果，包括统计置信区间。比较了各国患者层面的一生医院护理需求和人群层面的艾滋病影响，并将其与国家艾滋病流行情况和医疗保健系统的特征相关联。艾滋病患者在艾滋病阶段度过的天数中，有14%（英国）至24%（法国）的时间与医院有接触（无论是住院天数还是门诊就诊）。就国家艾滋病流行情况（流行病学影响）而言，意大利和希腊每百万人口的门诊接触水平较高。1995年，艾滋病估计所需病床数占全国急性护理医院可用病床总数的比例高达2.13%（西班牙）。1995年，意大利人均门诊就诊估计需求最高，相当于108个全职医生当量。在希腊和荷兰的案例研究中，评估了医院护理利用模式的差异与两国医疗保健系统的差异（人均病床数、医生和护士数以及两国医疗护理的一些定性特征）相对应。通过对国家医院护理利用数据进行标准化分析和标准化流行病学建模，可以对艾滋病医院护理进行国际比较。一生医院护理需求的估计是用于辅助医疗保健政策决策的成本效益分析的重要输入。
