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不同年龄段机械通气患者的成本比较。

Cost comparison of mechanically ventilated patients across the age span.

作者信息

Hayman W R, Leuthner S R, Laventhal N T, Brousseau D C, Lagatta J M

机构信息

Department of Pediatrics, Tripler Army Medical Center, Honolulu, HI, USA.

Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.

出版信息

J Perinatol. 2015 Dec;35(12):1020-6. doi: 10.1038/jp.2015.131. Epub 2015 Oct 15.

Abstract

OBJECTIVE

To compare the use of mechanical ventilation and hospital costs across ventilated patients of all ages, preterm through adults, in a nationally representative sample.

STUDY DESIGN

Secondary analysis of the 2009 Agency for Healthcare Research and Quality National Inpatient Sample.

RESULTS

A total of 1 107 563 (2.8%) patients received mechanical ventilation. For surviving ventilated patients, median costs for infants ⩽32 weeks' gestation were $51000 to $209 000, whereas median costs for older patients were lower from $17 000 to $25 000. For non-surviving ventilated patients, median costs were $27 000 to $39 000 except at the extremes of age; the median cost was $10 000 for <24 week newborns and $14 000 for 91+ year adults. Newborns of all gestational ages had a disproportionate share of hospital costs relative to their total volume.

CONCLUSION

Most intensive care unit resources at the extremes of age are not directed toward non-surviving patients. From a perinatal perspective, attention should be directed toward improving outcomes and reducing costs for all infants, not just at the earliest gestational ages.

摘要

目的

在一个具有全国代表性的样本中,比较所有年龄段(从早产儿到成人)接受机械通气患者的机械通气使用情况和住院费用。

研究设计

对2009年医疗保健研究与质量局全国住院患者样本进行二次分析。

结果

共有1107563名(2.8%)患者接受了机械通气。对于存活的接受机械通气的患者,孕周≤32周的婴儿的中位费用为51000美元至209000美元,而老年患者的中位费用较低,为17000美元至25000美元。对于未存活的接受机械通气的患者,除了年龄极端情况外,中位费用为27000美元至39000美元;孕周<24周的新生儿中位费用为10000美元,91岁及以上成人中位费用为14000美元。所有孕周的新生儿相对于其总体数量而言,在住院费用中所占比例过高。

结论

年龄极端情况下的大多数重症监护病房资源并非用于未存活患者。从围产期角度来看,应关注改善所有婴儿的预后并降低费用,而不仅仅是最早孕周的婴儿。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b49e/4821466/d469607d8490/nihms720581f1a.jpg

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