Van den Berghe Greet, Wouters Pieter J, Kesteloot Katrien, Hilleman Daniel E
Department of Critical Care, University of Leuven, and Department of Intensive Care Medicine, University Hospitals Leuven, Belgium.
Crit Care Med. 2006 Mar;34(3):612-6. doi: 10.1097/01.ccm.0000201408.15502.24.
To perform an analysis of healthcare resource utilization with intensive insulin therapy, which has recently been shown to reduce morbidity and mortality rates of mechanically ventilated critically ill patients in a surgical intensive care unit.
A post hoc cost analysis.
Surgical intensive care unit.
Patients were 1548 mechanically ventilated patients admitted to a surgical intensive care unit.
A post hoc cost analysis was conducted based on data collected prospectively as part of a large randomized controlled trial. The analysis performed was a healthcare resource utilization analysis in which the cost of hospitalization in the intensive care unit was determined based on length of stay and the frequency of crucial cost-generating morbid events occurring in the intensive and conventional insulin treatment groups. Sensitivity analyses were performed to evaluate the robustness of the findings. Discounting of costs was not performed as treatment was limited to the intensive care stay and follow-up was not continued beyond hospitalization.
In the intensive treatment group, total treatment cost was 109,838 Euros (144 Euros per patient). In the conventional treatment group, total treatment cost was 56,359 Euros (72 Euros per patient). The excess cost of intensive insulin therapy was 72 Euros per patient. The total hospitalization cost in the intensive treatment group was 6,067,237 Euros (7931 Euros per patient) compared with 8,275,394 Euros (10,569 Euros per patient) in the conventional treatment group. The excess cost of intensive care unit hospitalization in the conventional vs. intensive treatment group was 2638 Euros per patient. These intensive care unit benefits were not offset by additional costs for care on regular wards.
Intensive insulin therapy, which reduces morbidity and mortality rates of mechanically ventilated patients admitted to a surgical intensive care unit, is associated with substantial cost savings compared with conventional insulin therapy.
对强化胰岛素治疗的医疗资源利用情况进行分析，强化胰岛素治疗最近已被证明可降低外科重症监护病房中机械通气重症患者的发病率和死亡率。
事后成本分析。
外科重症监护病房。
1548例入住外科重症监护病房的机械通气患者。
基于作为一项大型随机对照试验的一部分前瞻性收集的数据进行事后成本分析。所进行的分析是一项医疗资源利用分析，其中根据重症监护病房的住院时长以及重症和常规胰岛素治疗组中发生的关键成本产生性不良事件的频率来确定重症监护病房的住院费用。进行敏感性分析以评估研究结果的稳健性。由于治疗仅限于重症监护病房住院期间且住院后未继续随访，因此未对成本进行贴现。
在强化治疗组中，总治疗成本为109,838欧元（每位患者144欧元）。在常规治疗组中，总治疗成本为56,359欧元（每位患者72欧元）。强化胰岛素治疗的额外成本为每位患者72欧元。强化治疗组的总住院成本为6,067,237欧元（每位患者7931欧元），而常规治疗组为8,275,394欧元（每位患者10,569欧元）。常规治疗组与强化治疗组相比，重症监护病房住院的额外成本为每位患者2638欧元。这些重症监护病房的益处并未被普通病房护理的额外成本所抵消。
强化胰岛素治疗可降低入住外科重症监护病房的机械通气患者的发病率和死亡率，与常规胰岛素治疗相比，可节省大量成本。
