Kai-Yang Lv, Shi-Hui Zhu, Hong-Tai Tang, Yi-Tao Jia, Zhao-Fan Xia, Dao-Feng Ben, Wei Lu, Guang-Qing Wang, Guang-Yi Wang, Shi-Chu Xiao, Da-Sheng Cheng, Bing Ma, Jian-Rong Zhang
Burn Center, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
Burns. 2009 Aug;35(5):738-45. doi: 10.1016/j.burns.2008.12.004. Epub 2009 Mar 21.
To reveal the characteristic and distribution of length of hospital stay (LOS) and direct hospitalisation costs of paediatric scald.
A prospective case series observation was performed from January 2005 to December 2006 at the Burn Center, Changhai Hospital, Shanghai, China. The information, such as demographics, clinical diagnosis and treatments since admission, of the paediatric scald patients included in the series was recorded. The direct cost of a treatment event was recorded into the price system when it was incurred. All cost data were summarised on completion of the study. The distribution of LOS and the hospitalisation costs were recorded by gender, age, total burn area, depth of burn, blood transfusion and patterns of treatment. Mann-Whitney signed-rank test was used to assess the differences between continuous, non-normally distributed variables, and multiple linear regression was used to model LOS and direct hospitalisation costs. Statistical analyses were undertaken with SPSS 15.0 statistical software.
Patients aged 3 years or less accounted for more than half of the total LOS and hospitalisation costs, patients with burn area less than 10%TBSA (total burn surface area) accounted for more than 70% of the total LOS and more than half of the hospitalisation costs and patients with second-degree burn accounted for more than 78% of the total LOS and hospitalisation costs. Depth of burn, area of burn, patterns of treatment and blood transfusion were independent predictors of LOS; whereas LOS, area of burn and blood transfusion were independent predictors of hospitalisation costs.
Paediatric scalds have particular characteristics in terms of distribution of LOS and direct hospitalisation costs and the factors influencing them. The data presented in this study should assist burn care practitioners and hospital epidemiologists estimate and compare the economic burden of paediatric burns at other institutions; it may also be useful in resource allocation and cost-effectiveness analysis of treatment versus prevention strategies.
揭示小儿烫伤住院时间（LOS）及直接住院费用的特征与分布情况。
于2005年1月至2006年12月在中国上海长海医院烧伤中心进行前瞻性病例系列观察。记录纳入该系列的小儿烫伤患者的人口统计学信息、入院后的临床诊断及治疗情况。治疗事件的直接费用在发生时录入价格系统。研究结束时汇总所有费用数据。按性别、年龄、烧伤总面积、烧伤深度、输血情况及治疗方式记录住院时间和住院费用的分布情况。采用曼-惠特尼符号秩检验评估连续的、非正态分布变量之间的差异，采用多元线性回归对住院时间和直接住院费用进行建模。使用SPSS 15.0统计软件进行统计分析。
3岁及以下患者的住院时间和住院费用占总数的一半以上，烧伤面积小于10%TBSA（烧伤总面积）的患者住院时间占总数的70%以上，住院费用占总数的一半以上，二度烧伤患者的住院时间和住院费用占总数的78%以上。烧伤深度、烧伤面积、治疗方式和输血是住院时间的独立预测因素；而住院时间、烧伤面积和输血是住院费用的独立预测因素。
小儿烫伤在住院时间和直接住院费用的分布及其影响因素方面具有特殊特征。本研究提供的数据应有助于烧伤护理从业者和医院流行病学家估计和比较其他机构小儿烧伤的经济负担；也可能有助于治疗与预防策略的资源分配和成本效益分析。
