Department of Haematological Medicine, Kings College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK
Aquarius Population Health, Bristol, UK.
J Antimicrob Chemother. 2015 Apr;70(4):1175-81. doi: 10.1093/jac/dku506. Epub 2014 Dec 21.
The direct cost of invasive fungal disease (IFD) includes antifungal drugs as well as diagnostic tests. The aim of this study was to determine these costs.
A total of 203 haematology patients were enrolled into the study and followed for a median of 556 days. Data were prospectively collected on antifungal drugs, diagnostic tests, length of stay and antibiotic usage.
The overall mean (IQR) cost of care per patient (using UK-based reference costs) was £88 911 (45 339-121 594), £61 509 (39 748-78 383), £50 332 (23 037-72 057) and £34 075 (19 928-43 900) for proven/probable IFD, possible IFD, not classified and no evidence of IFD, respectively (P<0.001). The attributable cost of IFD was £54 836. Inpatient hospital stay accounted for nearly 74% of costs. In proven/probable IFD inpatient care, antifungals, antibiotics and IFD status accounted for 68%, 25%, 5% and 2%, respectively, compared with 85%, 11%, 2% and 2%, respectively, for no IFD (P<0.001). Among the allogeneic transplant patients, £36 914 (60%) of the total cost (£60 917) was used during the first 100 days.
IFD was associated with longer length of stay and higher total overall cost of care, with attributable costs greater than £50 000 per case of IFD. Costs for inpatient stay far outstrip the cost of antifungal agents.
侵袭性真菌病（IFD）的直接成本包括抗真菌药物和诊断测试。本研究旨在确定这些成本。
共纳入 203 例血液科患者，中位随访时间为 556 天。前瞻性收集抗真菌药物、诊断测试、住院时间和抗生素使用情况的数据。
每位患者（使用英国参考成本）的总体平均（IQR）护理费用分别为确诊/疑似 IFD 为 £88911（45339-121594）、可能 IFD 为 £61509（39748-78383）、未分类为 IFD 为 £50332（23037-72057）和无 IFD 为 £34075（19928-43900）（P<0.001）。IFD 的归因成本为 £54836。住院治疗占总费用的近 74%。在确诊/疑似 IFD 患者中，住院治疗、抗真菌药物、抗生素和 IFD 状态分别占 68%、25%、5%和 2%，而无 IFD 患者分别占 85%、11%、2%和 2%（P<0.001）。在异基因移植患者中，总费用（£60917）的 £36914（60%）用于前 100 天。
IFD 与住院时间延长和总体护理费用增加有关，归因成本每例 IFD 超过 £50000。住院费用远远超过抗真菌药物的成本。
