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荷兰重症监护病房住院的微观成本研究。

A microcosting study of intensive care unit stay in the Netherlands.

作者信息

Tan Siok Swan, Hakkaart-van Roijen Leona, Al Maiwenn J, Bouwmans Clazien A, Hoogendoorn Marga E, Spronk Peter E, Bakker Jan

机构信息

Erasmus MC University Medical Center, Institute for Medical Technology Assessment, Rotterdam, Netherlands.

出版信息

J Intensive Care Med. 2008 Jul-Aug;23(4):250-7. doi: 10.1177/0885066608318661. Epub 2008 May 28.

Abstract

The primary objective of this study was to estimate the actual daily costs of intensive care unit stay using a microcosting methodology. As a secondary objective, the degree of association between daily intensive care unit costs and some patient characteristics was examined. This multicenter, retrospective cost analysis was conducted in the medical-surgical adult intensive care units of 1 university and 2 general hospitals in the Netherlands for 2006, from a hospital perspective. A total of 576 adult patients were included, consuming a total of 2868 nursing days. The mean total costs per intensive care unit day were 1911, with labour (33%) and indirect costs (33%) as the most important cost drivers. An ordinary least squares analysis including age, Nine Equivalent of Nursing Manpower Use score/Therapeutic Intervention Scoring System score, mechanical ventilation, blood products, and renal replacement therapy was able to predict 50% of the daily intensive care unit costs.

摘要

本研究的主要目的是使用微观成本核算方法估算重症监护病房住院的实际每日费用。作为次要目的,研究了每日重症监护病房费用与一些患者特征之间的关联程度。本多中心回顾性成本分析从医院角度出发,于2006年在荷兰一所大学的内科-外科成人重症监护病房以及两所综合医院开展。共纳入576例成年患者,总计消耗2868个护理日。重症监护病房每日平均总成本为1911,其中劳动力成本(33%)和间接成本(33%)是最重要的成本驱动因素。一项包含年龄、护理人力使用等效九分制/治疗干预评分系统评分、机械通气、血液制品和肾脏替代治疗的普通最小二乘法分析能够预测50%的重症监护病房每日费用。

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