Pittoni Giovanni M, Scatto Alessio
U.O. Anestesia e Rianimazione, Azienda Ospedaliera-Università di Padova, Padova, Italy.
Curr Opin Anaesthesiol. 2009 Apr;22(2):232-6. doi: 10.1097/ACO.0b013e328323f9a8.
Medical care costs represent a large proportion of the gross domestic product in developed countries, and intensive care units (ICUs) consume a significant amount of those resources. The aim of this review is to analyze how the healthcare cost problem is studied in critically ill patients.
Permanent staffing and other overhead costs have the greatest impact on ICU costs. A growing number of studies from around the world are quantifying the costs of ICU care. Mechanical ventilation, particularly in severely ill patients, and sepsis management are responsible for much of the economic burden in the ICU. New expensive therapies and life support systems make formal economic analyses necessary.
Although economic justification should not be the only issue to influence treatments offered in the ICU, increasing use of tools such as cost-benefit analyses is needed to help with medical decisions on the critically ill patient.
在发达国家,医疗费用在国内生产总值中占很大比例,而重症监护病房(ICU)消耗了大量此类资源。本综述的目的是分析如何在危重病患者中研究医疗成本问题。
长期人员配备和其他间接费用对ICU成本影响最大。世界各地越来越多的研究正在对ICU护理成本进行量化。机械通气,尤其是在重症患者中,以及脓毒症管理是ICU中大部分经济负担的原因。新的昂贵疗法和生命支持系统使得进行正式的经济分析成为必要。
尽管经济合理性不应是影响ICU所提供治疗的唯一因素,但需要更多地使用成本效益分析等工具来帮助做出关于危重病患者的医疗决策。