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治疗酒精和药物相关诊断的资源使用情况。

Resource use in treating alcohol- and drug-related diagnoses.

作者信息

Bramble James D, Sakowski Henry, Rich Eugene C, Esterbrooks Dennis

机构信息

Department of Pharmacy Sciences, School of Pharmacy and Health Professions, Creighton University, Omaha, NE 68178, USA.

出版信息

J Gen Intern Med. 2004 Jan;19(1):36-42. doi: 10.1111/j.1525-1497.2004.20803.x.

Abstract

OBJECTIVE

This study examined the variations in hospital resource use in the treatment of alcohol and drug diagnoses. Specifically, the study tested 2 hypotheses: 1). patients treated in teaching hospitals will have shorter lengths of stay and lower hospital charges than patients treated in nonteaching hospitals; and 2). patients treated in hospitals with more experience treating these conditions will have shorter lengths of stay and lower hospital charges.

DESIGN

A retrospective cross-sectional study design used data from the 1996 Health Care Utilization Project to test the proposed hypotheses.

PATIENTS/PARTICIPANTS: The population for this study consisted of patients over 18 years old with an acute alcohol- or drug-related discharge diagnostic related group code.

MEASUREMENT AND MAIN RESULTS

The variables of interest were teaching hospital status, as defined by the Council of Teaching Hospitals, and hospital experience, defined as the ratio of alcohol- and drug-related diagnoses to the hospital's total admissions. Measures of hospital resource use included the patient's length of stay and total hospital charges. Patients treated at hospitals with relatively more experience in treating alcohol- and drug-related diagnoses had 10.3% (US dollars 321) lower total charges (P =.017).

CONCLUSIONS

Similar to research for high-volume surgical hospitals, these findings confirm that hospitals that have greater experience with complex medical conditions such as alcohol and drug intoxication and withdrawal may be more efficient. This important finding provides a rationale for further exploration of the key factors associated with higher quality and more efficient care for complex medical conditions.

摘要

目的

本研究探讨了治疗酒精和药物相关诊断时医院资源使用情况的差异。具体而言,该研究检验了两个假设:1)教学医院的患者住院时间比非教学医院的患者短,住院费用也更低;2)治疗这些疾病经验更丰富的医院的患者住院时间更短,住院费用更低。

设计

采用回顾性横断面研究设计,使用1996年医疗保健利用项目的数据来检验所提出的假设。

患者/参与者:本研究的人群包括18岁以上患有急性酒精或药物相关出院诊断相关组代码的患者。

测量与主要结果

感兴趣的变量是教学医院状态(由教学医院委员会定义)和医院经验(定义为酒精和药物相关诊断与医院总入院人数的比率)。医院资源使用的指标包括患者的住院时间和住院总费用。在治疗酒精和药物相关诊断方面经验相对更丰富的医院治疗的患者总费用降低了10.3%(321美元)(P = 0.017)。

结论

与对高容量外科医院的研究类似,这些发现证实,对酒精和药物中毒及戒断等复杂医疗状况有更多经验的医院可能效率更高。这一重要发现为进一步探索与复杂医疗状况的更高质量和更高效护理相关的关键因素提供了理论依据。

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