Cavallo M C, Lazzaro C, Tabacchi M, Langer M, Salvo I, Serra G, Taddei C
CeRGAS Universitá L. Bocconi, Milan, Italy.
Minerva Anestesiol. 2001 Jan-Feb;67(1-2):41-53.
The Italian hospital payment system based on DRG doesn t properly include Intensive Care Units (ICU) costs. Since great emphasis has been recently given to rationing health care resources, assessing ICU costs seems to be dramatically relevant. Aim of the study was to assess the average yearly cost and the cost per diem of a sample of Italian multispecialistic ICU wards.
In September 1995, a questionnaire concerning data on variable and fixed cost was sent to 25 Italian ICU wards, 11 NHS hospital-based (Northern Italy: 5; Central Italy: 4; Southern Italy: 2) and 14 school of medicine-based (Northern Italy: 7; Central Italy: 5; Southern Italy: 2). Variable cost data included: disposable, drugs, blood and blood-derived products, physical tests, chemical and microbiological routines, instrumental diagnostic procedures and physiotherapy. Concerning fixed costs, data on personnel and equipment were requested. In addition, some hospital overheads data (utilities; power; heating; maintenance; cleaning; laundry; accounting; waste disposal; cafeteria) were collected.
On the basis of the 12 questionnaires returned (Northern Italy: 9; Central Italy: 3; Southern Italy: 0), the yearly cost of an ICU ward is Liras 4,580,032,000 (range 2,739,277,000-7,704,292,000), whereas the average cost per diem is Liras 1,802,000 (range 1,234,000-3,179,000). Cost of personnel is about 61% of the above mentioned costs.
Despite the lack of questionnaires from Southern Italy and the unavailability of some data concerning both the cost of equipment and the overheads, the remarkable average cost values obtained could support further research.
意大利基于诊断相关分组（DRG）的医院支付系统未妥善纳入重症监护病房（ICU）的费用。鉴于最近大力强调卫生保健资源的合理分配，评估ICU费用显得极为重要。本研究的目的是评估意大利多专科ICU病房样本的年均费用及每日费用。
1995年9月，向25个意大利ICU病房发放了一份关于可变成本和固定成本数据的问卷，其中11个基于国民健康服务体系（NHS）的医院（意大利北部：5个；意大利中部：4个；意大利南部：2个），14个基于医学院（意大利北部：7个；意大利中部：5个；意大利南部：2个）。可变成本数据包括：一次性用品、药品、血液及血液制品、体格检查、化学和微生物常规检查、仪器诊断程序及物理治疗。关于固定成本，要求提供人员和设备的数据。此外，还收集了一些医院间接费用数据（水电费、电力、供暖、维护、清洁、洗衣、会计、废物处理、自助餐厅）。
根据回收的12份问卷（意大利北部：9份；意大利中部：3份；意大利南部：0份），一个ICU病房的年费用为45.80032亿里拉（范围为27.39277亿里拉至77.04292亿里拉），而日均费用为180.2万里拉（范围为123.4万里拉至317.9万里拉）。人员成本约占上述成本的61%。
尽管缺乏来自意大利南部的问卷，且一些关于设备成本和间接费用的数据无法获取，但所获得的显著平均成本值可为进一步研究提供支持。
