Csomós Akos, Hoffer Gábor, Fülesdi Béla, Ludwig Endre
Markhot Ferenc Megyei Kórház, Központi Aneszteziológiai es Intenzív Betegellátó Osztály, Eger.
Orv Hetil. 2005 Jul 17;146(29):1543-7.
The aim of the study was to determine the incidence and mortality of sepsis and to analyse the direct costs of severe sepsis treated in intensive care unit in Hungary.
National data on sepsis demography, incidence and mortality were collected using the database of Hungarian Health Fund, Year 2001. The cost of treating severe sepsis was calculated by retrospective data collection of resource use in 6 ICUs. Personnel costs were calculated from annual salary report and the indirect costs were estimated by the financial director of each participating hospital. To validate retrospective data, the ICUs organised a prospective cost-analysis during one month period.
There were 2659 patients reported with septic DRG code in Hungary. The mortality of sepsis is 42.7%, the average length of stay is 14.5 days (SD-17.4). Patients discharged from ICU after sepsis remained in hospital for further 18.1 days (SD-18). The mortality of severe sepsis in the pilot sample (n = 70) was found to be 64.2%, with average length of stay 15.5 (SD-10.2). The average daily ICU cost of severe sepsis is HUF 107 200 (429 Euro). Consumables account for 68% of total cost, the personnel 26.3% and clinical support 5.7%.
The mortality of severe sepsis is high and the cost of treating severe sepsis is four times more then the average ICU daily cost. To take into account the much longer length of stay (15.5 vs. 5 day), annual cost of septic patients is HUF 4.4 billions (1 140000 Euro) in Hungary.
本研究旨在确定脓毒症的发病率和死亡率，并分析匈牙利重症监护病房中治疗严重脓毒症的直接费用。
利用匈牙利健康基金2001年数据库收集有关脓毒症人口统计学、发病率和死亡率的全国数据。通过对6个重症监护病房资源使用情况进行回顾性数据收集，计算治疗严重脓毒症的费用。人员成本根据年薪报告计算，间接成本由各参与医院的财务主管估算。为验证回顾性数据，重症监护病房在一个月内组织了前瞻性成本分析。
匈牙利有2659例患者报告有脓毒症诊断相关分组代码。脓毒症的死亡率为42.7%，平均住院时间为14.5天（标准差-17.4）。脓毒症后从重症监护病房出院的患者在医院还需再住院18.1天（标准差-18））。在试点样本（n = 70）中，严重脓毒症的死亡率为64.2%，平均住院时间为15.5天（标准差-10.2）。严重脓毒症的重症监护病房平均每日费用为107200匈牙利福林（429欧元））。耗材占总成本的68%，人员占26.3%，临床支持占5.7%。
严重脓毒症的死亡率很高，治疗严重脓毒症的费用比重症监护病房的平均每日费用高出四倍。考虑到住院时间长得多（15.5天对5天），匈牙利脓毒症患者的年度费用为44亿匈牙利福林（114万欧元））。
