Moerer Onnen, Schmid Alexandra, Hofmann Michael, Herklotz Anja, Reinhart Konrad, Werdan Karl, Schneider Heinz, Burchardi Hilmar
Department of Anesthesiology, Emergency, and Intensive Care Medicine, University Hospital Göttingen, Robert-Koch-Strasse 40, 37070 Göttingen, Germany.
Intensive Care Med. 2002 Oct;28(10):1440-6. doi: 10.1007/s00134-002-1429-9. Epub 2002 Aug 17.
To determine the direct costs of severe sepsis patients in German intensive care units (ICUs).
Retrospective electronic data analysis.
Three adult intensive care units (surgical/medical) in three university hospitals in Germany.
385 patients identified by standard definitions as suffering from severe sepsis.
A bottom-up approach was used to determine the direct ICU cost on actual resource use (medication, laboratory tests, microbiological analysis, disposables, and clinical procedures) for patients with severe sepsis. To determine the total direct costs, center-specific personnel and basic bed ("hotel") costs were added to total resources consumed. Average hospital mortality of severely septic patients was 42.6%. Mean ICU length of stay (LOS) was 16.6 days. Survivors stayed on average 4 days longer than nonsurvivors. The mean direct ICU costs of care were 23,297+/-18,631 euros per patient and 1,318 euros per day. In comparison, average daily charges being paid for an ICU patient by the health care system in Germany are 851 euros (based on official statistics). Nonsurvivors were more expensive than survivors in total direct costs (25,446 vs. 21,984 euros) and in per day direct cost (1,649 vs. 1,162 euros). Medication makes up the largest part of the direct costs, followed by expenses for personnel. CONCLUSIONS. Patients with severe sepsis have a high ICU mortality rate and long ICU LOS and are substantially expensive to treat. Nonsurviving septic patients are more costly than survivors despite shorter ICU LOS. This is due to higher medication costs indicating increased efforts to keep patients alive.
确定德国重症监护病房（ICU）中严重脓毒症患者的直接费用。
回顾性电子数据分析。
德国三所大学医院的三个成人重症监护病房（外科/内科）。
385名根据标准定义被确定为患有严重脓毒症的患者。
采用自下而上的方法，根据严重脓毒症患者实际资源使用情况（药物、实验室检查、微生物分析、一次性用品和临床操作）确定ICU直接费用。为确定总直接费用，将各中心特定的人员和基本床位（“病房”）费用加到消耗的总资源费用上。严重脓毒症患者的平均医院死亡率为42.6%。ICU平均住院时间（LOS）为16.6天。幸存者的平均住院时间比非幸存者长4天。每位患者的ICU护理平均直接费用为23,297±18,631欧元，每天1,318欧元。相比之下，德国医疗保健系统为一名ICU患者支付的平均每日费用为851欧元（基于官方统计数据）。非幸存者的总直接费用（25,446欧元对21,984欧元）和每日直接费用（1,649欧元对1,162欧元）均高于幸存者。药物费用占直接费用的最大部分，其次是人员费用。
严重脓毒症患者的ICU死亡率高、住院时间长，治疗费用高昂。尽管非存活脓毒症患者的ICU住院时间较短，但费用却比存活患者更高。这是由于药物费用较高，表明为维持患者生命付出了更多努力。
