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脑出血后的管理模式与医疗保健利用。一项从德国社会视角进行的疾病成本研究。

Management patterns and health care use after intracerebral hemorrhage. a cost-of-illness study from a societal perspective in Germany.

作者信息

Weimar Christian, Weber Carsten, Wagner Markus, Busse Otto, Haberl Roman Ludwig, Lauterbach Karl W, Diener Hans Christoph

机构信息

Department of Neurology, University of Essen, Germany.

出版信息

Cerebrovasc Dis. 2003;15(1-2):29-36. doi: 10.1159/000067119.

Abstract

BACKGROUND

The German cost-of-illness study of stroke is a multicenter study in 6 departments of internal medicine, 9 departments of general neurology and 15 departments of neurology with an acute stroke unit. The aims of this study are to describe the management patterns, cost of treatment and overall resource utilization after intracerebral hemorrhage (ICH) as well as the major differences to ischemic stroke (IS).

METHODS

During a 12-month period, 30 participating centers with a special interest in stroke prospectively included 586 patients with ICH which were collected in a joint data bank. About 75% of all patients could be centrally followed up via structured telephone interviews after 3 and 12 months to assess further acute hospital and rehabilitation stays, outpatient resource utilization, functional outcome and quality of life.

RESULTS

Mortality after 3 months (33.5%) was markedly higher than in patients with IS from the same hospitals. Accordingly, only 30.9% of patients had regained independent functional status after 3 months. Cumulative cost of treatment amounted to 5301 EUR for inpatient stay in the documenting hospital and 8920 EUR for the overall hospital stay including rehabilitation. Mean direct cost after discharge during the first year amounted to 4598 EUR and the loss of work force was equivalent to 5537 EUR in all surviving patients.

CONCLUSION

This study provides a comprehensive overview of patient characteristics, treatment strategies and health care cost of ICH from a societal perspective in Germany.

摘要

背景

德国卒中疾病成本研究是一项多中心研究,涉及6个内科科室、9个普通神经科科室以及15个设有急性卒中单元的神经科科室。本研究的目的是描述脑出血(ICH)后的治疗模式、治疗成本和总体资源利用情况,以及与缺血性卒中(IS)的主要差异。

方法

在12个月的时间里,30个对卒中特别感兴趣的参与中心前瞻性纳入了586例ICH患者,并将其收集到一个联合数据库中。约75%的患者在3个月和12个月后可通过结构化电话访谈进行集中随访,以评估进一步的急性住院和康复住院情况、门诊资源利用情况、功能结局和生活质量。

结果

3个月后的死亡率(33.5%)明显高于同医院的IS患者。因此,只有30.9%的患者在3个月后恢复了独立功能状态。记录医院的住院治疗累积费用为5301欧元,包括康复在内的总体住院费用为8920欧元。所有存活患者出院后第一年的平均直接费用为4598欧元,劳动力损失相当于5537欧元。

结论

本研究从德国社会角度全面概述了ICH患者的特征、治疗策略和医疗保健成本。

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