Bartolomé M, Almirall J, Morera J, Pera G, Ortún V, Bassa J, Bolíbar I, Balanzó X, Verdaguer A
Consorci Sanitari de Mataró, Mataró, Spain.
Eur Respir J. 2004 Apr;23(4):610-6. doi: 10.1183/09031936.04.00076704.
In a population-based study, the consumption of resources for treating adult patients with community-acquired pneumonia was determined. During a 2-yr period, all cases with a clinical and radiological suspicion of community-acquired pneumonia that occurred in patients aged > 14 yrs in a community of 74,610 inhabitants were investigated prospectively. Of 292 cases with a suspicion of community-acquired pneumonia, 224 were included (18.5% misdiagnoses). The mean number of visits per patient was 4.5 (72% in the primary care setting). Inpatient care was recommended in 59.8% of cases; after discharge, 44% of patients were managed in outpatient clinics. The mean direct cost of pneumonia treated in the hospital setting was [symbol: see text] (euros) 1,553, whereas the mean cost of cases treated as outpatients was [symbol: see text] 196. A total of 15.7% of admissions were considered inappropriate and the length of stay could have been reduced by 3.5 days in the most severe cases. A reduction in inappropriate admissions and lengths of hospital stay would result in a decrease in cost of 17.4%. Community-acquired pneumonia in Maresme, Spain, occurs at a low incidence, although with a high percentage of hospitalisations (in part inappropriate), resulting in considerable costs.
在一项基于人群的研究中，确定了治疗社区获得性肺炎成年患者的资源消耗情况。在为期2年的时间里，对一个有74,610名居民的社区中年龄大于14岁的临床和影像学疑似社区获得性肺炎的所有病例进行了前瞻性调查。在292例疑似社区获得性肺炎病例中，224例被纳入研究（误诊率为18.5%）。每位患者的平均就诊次数为4.5次（72%在初级保健机构）。59.8%的病例建议住院治疗；出院后，44%的患者在门诊接受治疗。在医院环境中治疗肺炎的平均直接费用为1553欧元，而门诊治疗病例的平均费用为196欧元。总共15.7%的入院被认为是不适当的，在最严重的病例中住院时间本可缩短3.5天。减少不适当的入院和住院时间将使费用降低17.4%。西班牙马雷斯梅地区的社区获得性肺炎发病率较低，尽管住院率较高（部分不适当），导致费用相当可观。
