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[德国急性冠状动脉综合征治疗中出血所致的费用]

[Costs caused by bleeds within the therapy of acute coronary syndromes in Germany].

作者信息

Bufe Alexander, Frey Simon, Briswalter Stéphanie

机构信息

Medizinische Klinik 3 - Interventionelle Kardiologie, HELIOS Klinikum Wuppertal - Herzzentrum, Universität Witten/Herdecke, Herdecke, Germany.

出版信息

Herz. 2009 Sep;34(6):479-84. doi: 10.1007/s00059-009-3189-6. Epub 2009 Sep 27.

Abstract

PURPOSE

To estimate the resources and subsequent costs, to manage bleeds among patients with acute coronary syndrome (ACS) who are treated with antithrombotics or antiplatelets. Bleeds are relatively common but there is little information on the resource use and costs associated with these bleeds. This paper provides estimates by type of bleed to be used in analyses of therapies for managing ACS patients.

METHODS

Retrospective chart review of ACS patients experiencing a bleed while hospitalized was conducted in Germany. Qualifying bleeds included symptomatic intracranial hemorrhage (IB), retroperitoneal hemorrhage (RB), gastrointestinal hemorrhage (GB), decrease in hemoglobin by > or = 3 g/dl (HA), puncture site bleed (PS), transfusion of > or = 2 units of blood products, and fatal bleeds.

RESULTS

Records of 59 German ACS patients were included in the analysis. The average cost per patient was 1,995 Euros. Costs by bleed type were 2,531 Euros (IB), 3,567 Euros (RB), 3,616 Euros (GB), 891 Euros (HA), 1,379 Euros (PS), and 5,415 Euros (transfusions).

CONCLUSION

German hospitals are paid by case severity and diagnosis. Understanding the full costs of managing ACS patients and related bleeds may help decision-making.

摘要

目的

评估资源及后续成本,以管理接受抗血栓药或抗血小板药治疗的急性冠状动脉综合征(ACS)患者的出血情况。出血相对常见,但关于这些出血相关的资源使用和成本的信息较少。本文按出血类型提供了估计值,用于分析ACS患者的治疗管理。

方法

对德国住院期间发生出血的ACS患者进行回顾性病历审查。符合条件的出血包括有症状的颅内出血(IB)、腹膜后出血(RB)、胃肠道出血(GB)、血红蛋白下降≥3 g/dl(HA)、穿刺部位出血(PS)、输注≥2单位血液制品以及致命性出血。

结果

分析纳入了59例德国ACS患者的记录。每位患者的平均成本为1995欧元。各类出血的成本分别为:2531欧元(IB)、3567欧元(RB)、3616欧元(GB)、891欧元(HA)、1379欧元(PS)以及5415欧元(输血)。

结论

德国医院按病例严重程度和诊断收费。了解管理ACS患者及相关出血的全部成本可能有助于决策。

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