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综合医院中自杀未遂的直接和间接成本:疾病成本研究

Direct and indirect cost of attempted suicide in a general hospital: cost-of-illness study.

作者信息

Sgobin Sara Maria Teixeira, Traballi Ana Luisa Marques, Botega Neury José, Coelho Otávio Rizi

机构信息

Department of Medical Psychology and Psychiatry, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.

Department of Cardiology, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.

出版信息

Sao Paulo Med J. 2015 May-Jun;133(3):218-26. doi: 10.1590/1516-3180.2014.8491808. Epub 2015 Jun 1.

Abstract

CONTEXT AND OBJECTIVE

Knowledge of socioeconomic impact of attempted suicide may sensitize managers regarding prevention strategies. There are no published data on this in Brazil. The aim here was to describe the direct and indirect costs of care of hospitalized cases of attempted suicide and compare these with the costs of acute coronary syndrome cases.

DESIGN AND SETTING

Cost-of-illness study at a public university hospital in Brazil.

METHOD

The costs of care of 17 patients hospitalized due to attempted suicide were compared with those of 17 acute coronary syndrome cases at the same hospital, over the same period. The direct costs were the summation of the hospital and out-of-hospital costs resulting from the event, determined from the medical records. The indirect costs were estimated through the human capital lost. The Mann-Whitney test and analysis of covariance (ANCOVA) with transformation adjusted for age were used for comparisons.

RESULTS

The average costs per episode of attempted suicide were: direct cost, US$ 6168.65; indirect cost, US$ 688.08; and total cost, US$ 7163.75. Comparative analysis showed a difference between the indirect costs to family members, with significantly higher costs in the attempted suicide group (P = 0.0022).

CONCLUSION

The cost of care relating to attempted suicide is high and the indirect cost to family members reinforces the idea that suicidal behavior not only affects the individual but also his social environment.

摘要

背景与目的

了解自杀未遂的社会经济影响可能会使管理人员对预防策略更加敏感。巴西尚无关于此方面的公开数据。本文旨在描述自杀未遂住院病例的直接和间接护理成本,并将其与急性冠状动脉综合征病例的成本进行比较。

设计与地点

在巴西一所公立大学医院进行的疾病成本研究。

方法

将17例因自杀未遂住院患者的护理成本与同期同一医院的17例急性冠状动脉综合征病例的护理成本进行比较。直接成本是该事件导致的医院和院外成本之和,通过病历确定。间接成本通过损失的人力资本进行估算。使用曼-惠特尼检验和经年龄调整的协方差分析(ANCOVA)进行比较。

结果

自杀未遂每次发作的平均成本为:直接成本6168.65美元;间接成本688.08美元;总成本7163.75美元。比较分析显示,家庭成员的间接成本存在差异,自杀未遂组的成本显著更高(P = 0.0022)。

结论

与自杀未遂相关的护理成本很高,家庭成员的间接成本强化了这样一种观念,即自杀行为不仅影响个人,还会影响其社会环境。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/765b/10876379/1613773bc6b3/1806-9460-spmj-133-03-218-gf1.jpg

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