Plumridge R J
Department of Pharmacy, Fremantle Hospital, WA.
Med J Aust. 1990 Nov 5;153(9):516-8.
The cost of preparing and administering intravenous antibiotics in an Australian teaching hospital was determined. The costs associated with acquisition, delivery (administration system, ancillary equipment, labour), and laboratory monitoring for potential toxicity were calculated. Standard regimens based on antibiotic guidelines were used to compile the daily total cost. The results indicate that these components affect the daily total cost of individual antibiotics in different ways. Acquisition cost is often a poor predictor of total cost, which ranges from 1.2 times to almost eight times the acquisition cost. Less frequent administration reduces total costs substantially, as does slow injection compared with infusion. Laboratory costs constitute between 3.6% and 23% of the daily total cost and are most pronounced with antibiotics that have low acquisition costs. Antibiotic cost containment should not focus on acquisition cost alone. Daily total cost to administer antibiotics is a more appropriate and accurate costing method. Hospitals must acknowledge the need for innovative resource allocation methods which recognise this fact.
确定了澳大利亚一家教学医院中准备和使用静脉注射抗生素的成本。计算了与采购、给药(给药系统、辅助设备、劳动力)以及潜在毒性的实验室监测相关的成本。基于抗生素指南的标准方案被用于编制每日总成本。结果表明,这些组成部分以不同方式影响单个抗生素的每日总成本。采购成本往往不能很好地预测总成本,总成本是采购成本的1.2倍至近8倍。给药频率较低会大幅降低总成本,与输液相比,缓慢注射也是如此。实验室成本占每日总成本的3.6%至23%,在采购成本较低的抗生素中最为显著。抗生素成本控制不应仅关注采购成本。使用抗生素的每日总成本是一种更合适、更准确的成本计算方法。医院必须认识到需要采用能够认识到这一事实的创新资源分配方法。