Viart H, Combe C, Martinelli T, Thomas J, Hida H
Service de pharmacie, centre hospitalier de Valence, 179, boulevard du Maréchal-Juin, 26953 Valence cedex, France.
Service radiologie, centre hospitalier de Valence, 179, boulevard du Maréchal-Juin, 26953 Valence cedex, France.
Ann Pharm Fr. 2015 May;73(3):239-44. doi: 10.1016/j.pharma.2014.08.001. Epub 2014 Sep 26.
Peripherally Inserted Central Catheter or PICC Line and implanted subcutaneous ports are two types of central catheters allowing drug administration and blood samplings. These two devices are very controversial (because of infectious and thrombotic complications), it seemed interesting to estimate their cost of implantation and to correlate them with the reimbursement by the Health Insurance.
Direct (material and drugs) and indirect (use of the room and staff) costs were prospectively evaluated for PICC Lines and implanted subcutaneous ports.
The global costs of the implantation of a PICC Line and of an implanted subcutaneous port in the interventional radiology room and in the operating room were respectively evaluated at 220.2 €, 286.6 € and 666.3 €.
DISCUSSION-CONCLUSION: Only a PICC Line in outpatients can be reimbursed by the health insurance; which amounts to 110.4 €. The establishment therefore loses money with every implantation. However, PICC Lines offer to the patients a fast access to a central venous way and thus an optimal therapeutic care, fulfilling one of the main missions of the public health institutions. Implanted subcutaneous ports are economically worth being implanted only in ambulatory inpatients. Its implantation in radiology seemed more profitable because the indirect costs were much more moderate.
外周静脉穿刺中心静脉导管(PICC 导管)和植入式皮下端口是两种用于给药和采血的中心静脉导管。这两种装置存在很大争议(由于感染和血栓形成并发症),评估其植入成本并将其与医疗保险报销情况相关联似乎很有意思。
前瞻性评估了 PICC 导管和植入式皮下端口的直接成本(材料和药物)和间接成本(房间和工作人员的使用)。
在介入放射科和手术室植入 PICC 导管和植入式皮下端口的总成本分别评估为 220.2 欧元、286.6 欧元和 666.3 欧元。
讨论 - 结论:只有门诊患者的 PICC 导管可由医疗保险报销;报销金额为 110.4 欧元。因此,每次植入医院都会亏损。然而,PICC 导管为患者提供了快速进入中心静脉通路的途径,从而实现了最佳治疗护理,履行了公共卫生机构的主要使命之一。植入式皮下端口仅在门诊住院患者中植入在经济上是值得的。在放射科植入似乎更有利可图,因为间接成本要低得多。