Gregori D, Scarinzi C, Berchialla P, Snidero S, Rahim Y, Stancu A, Corradetti R, Pagano E, Morra B, Salerni L, Passali D
Department of Public Health and Microbiology, University of Torino, Via Santena 5bis, 10126 Torino, Italy.
Int J Pediatr Otorhinolaryngol. 2007 Sep;71(9):1391-8. doi: 10.1016/j.ijporl.2007.05.013. Epub 2007 Jun 27.
This paper addressed the impact in terms of direct costs of the injuries in children due to foreign bodies in the upper aero-digestive tract.
Two thousand one hundred and three consecutive cases were collected from 2000 to 2002 in 16 European hospitals, 1 hospital for each participating country, and referred to children aged until 14 who had FB injuries. Costs were based on the extraction of the FB procedures and on hospitalization length, based on DRGs. Determinants of costs and of length of stay (LOS) were analyzed using a multilevel model.
The major cost of the treatment of FB injuries is covered by the ENT Departments, which are usually the first choice of referral, directly from the patients. Children had a mean LOS of 2.13 days (95% C.I. 1.99-2.29). Treatment of the FB was associated with a mean cost of euro 1017.37 (95% C.I. 963.27-1073.51). In the multivariable analysis higher costs are related to the modality of arrival to the hospital by walk, to the site of the injury (ICD-933, ICD-934, ICD-935 in particular) and to the use of surgery in removing the FB.
Foreign bodies injuries are posing a great threat not only with regards to the clinical aspects but also from the public health perspective, their treatment being associated with high costs, in particular when surgery is needed.
本文探讨上呼吸道和消化道异物导致儿童受伤所产生的直接成本影响。
2000年至2002年期间，从16家欧洲医院连续收集了2103例病例，每个参与国1家医院，病例涉及14岁及以下有异物损伤的儿童。成本基于异物取出手术及根据疾病诊断相关分组（DRGs）确定的住院时长。使用多水平模型分析成本及住院时间（LOS）的决定因素。
耳鼻喉科承担了异物损伤治疗的主要费用，通常是患者直接转诊的首选科室。儿童的平均住院时间为2.13天（95%置信区间1.99 - 2.29）。异物治疗的平均费用为1017.37欧元（95%置信区间963.27 - 1073.51）。在多变量分析中，较高的费用与步行前往医院的方式、损伤部位（特别是ICD - 933、ICD - 934、ICD - 935）以及使用手术取出异物有关。
异物损伤不仅在临床方面构成巨大威胁，从公共卫生角度来看也是如此，其治疗成本高昂，特别是在需要手术时。
