Wasserfallen Jean-Blaise, Bossuat Christine, Perrin Eliane, Cotting Jacques
Health Technology Assessment Unit, University Hospital (CHUV), Lausanne, Switzerland.
Swiss Med Wkly. 2006 Dec 23;136(49-50):800-4. doi: 10.4414/smw.2006.11585.
Hospitalisation of a child in a paediatric intensive care unit (PICU) involves major stress for parents. They wish to stay at their child's bedside while at the same time giving the usual attention to their other children. The resultant out-of-pocket expenses have rarely been studied.
Over a 6-month period all the families of children hospitalised in our PICU for more than 4 days, speaking French and insured by our social security system, were eligible for inclusion. Participation was proposed only after diagnosis, treatment and prognosis had been determined. Costs were retrieved from a diary list of customised items and computed as the amount in excess of usual expenses until the end of the hospital stay.
117 children were hospitalised in our PICU for a total of 131 stays. The families of 16 fulfilled the inclusion criteria. One dropped out after a week at the parents' request. The children's age was 2.9 +/- 3.8 years and 67% were male. The majority had malformations (53%) or infections (33%). The total length of stay was 49 +/- 51 days, of which 24 +/- 41 were spent in the PICU. On average, parents spent CHF 86 +/- 31 every day, mainly on travel and meals. Over the entire hospital stay their expenses amounted to CHF 4,078 +/- 4,552.
Direct out-of-pocket expenses for parents of children hospitalised in the PICU are considerable. Improvement in the social security system may be necessary to address this issue.
儿童入住儿科重症监护病房（PICU）会给家长带来巨大压力。他们希望守在孩子床边，同时还要像往常一样照顾其他孩子。由此产生的自付费用很少被研究过。
在6个月的时间里，所有在我们PICU住院超过4天、说法语且由我们的社会保障系统承保的儿童家庭都符合纳入条件。仅在确定诊断、治疗和预后后才提议参与。费用从定制项目的日记清单中获取，并计算为住院结束前超过正常费用的金额。
117名儿童在我们的PICU住院，共住院131次。16个家庭符合纳入标准。其中1个家庭应家长要求在一周后退出。儿童年龄为2.9±3.8岁，67%为男性。大多数儿童患有畸形（53%）或感染（33%）。总住院时间为49±51天，其中24±41天在PICU度过。平均而言，家长每天花费86±31瑞士法郎，主要用于交通和餐饮。在整个住院期间，他们的费用总计为4078±4552瑞士法郎。
PICU住院儿童家长的直接自付费用相当可观。可能需要改进社会保障系统来解决这个问题。
