Northrup Jill M, Miller Ann C, Nardell Edward, Sharnprapai Sharon, Etkind Sue, Driscoll Jeffrey, McGarry Michael, Taber Harry W, Elvin Paul, Qualls Noreen L, Braden Christopher R
Massachusetts Department of Public Health, Boston, Massachusetts, USA.
Emerg Infect Dis. 2002 Nov;8(11):1264-70. doi: 10.3201/eid0811.020387.
We estimated direct medical and nonmedical costs associated with a false diagnosis of tuberculosis (TB) caused by laboratory cross-contamination of Mycobacterium tuberculosis cultures in Massachusetts in 1998 and 1999. For three patients who received misdiagnoses of active TB disease on the basis of laboratory cross-contamination, the costs totaled U.S. dollars 32618. Of the total, 97% was attributed to the public sector (local and state health departments, public health hospital and laboratory, and county and state correctional facilities); 3% to the private sector (physicians, hospitals, and laboratories); and <1% to the patient. Hospitalizations and inpatient tests, procedures, and TB medications accounted for 69% of costs, and outpatient TB medications accounted for 18%. The average cost per patient was dollars 10873 (range, dollars 1033-dollars 21306). Reducing laboratory cross-contamination and quickly identifying patients with cross-contaminated cultures can prevent unnecessary and potentially dangerous treatment regimens and anguish for the patient and financial burden to the health-care system.
我们估算了1998年和1999年马萨诸塞州因结核分枝杆菌培养物实验室交叉污染导致的结核病(TB)误诊所产生的直接医疗和非医疗费用。对于3例因实验室交叉污染而被误诊为活动性结核病的患者,费用总计32618美元。其中,97%归因于公共部门(地方和州卫生部门、公共卫生医院和实验室以及县和州惩教设施);3%归因于私营部门(医生、医院和实验室);不到1%归因于患者。住院治疗、住院检查、手术及结核病药物占费用的69%,门诊结核病药物占18%。每位患者的平均费用为10873美元(范围为1033美元至21306美元)。减少实验室交叉污染并快速识别培养物交叉污染的患者,可避免不必要且可能危险的治疗方案,减轻患者的痛苦以及医疗系统的经济负担。