印度西部私立医院住院患者直接医疗成本与药物治疗成本的回顾性分析
A Retrospective Analysis of Direct Medical Cost and Cost of Drug Therapy in Hospitalized Patients at Private Hospital in Western India.
作者信息
Shelat Prakash R, Kumbar Shivaprasad Kalakappa
机构信息
Assistant Professor, Department of Pharmacology, P.D.U. Govt. Medical College , Rajkot, Gujarat, India .
Assistant Professor, Department of Pharmacology, BLDEU's Shri B. M. Patil Medical College , Bijapur, Karnataka, India .
出版信息
J Clin Diagn Res. 2015 Nov;9(11):FC09-12. doi: 10.7860/JCDR/2015/15121.6724. Epub 2015 Nov 1.
BACKGROUND
Pharmacoeconomics is analytical tool to know cost of hospitalization and its effect on health care system and society. In India, apart from the government health services, private sector also play big role to provide health care services.
OBJECTIVE
To study the direct medical cost and cost of drug therapy in hospitalized patients at private hospital.
MATERIALS AND METHODS
A retrospective study was conducted at private hospital in a metro city of Western India. Total 400 patients' billing records were selected randomly for a period from 01/01/2013 to 31/12/2014. Data were collected from medical record of hospital with permission of medical director of hospital. Patients' demographic profile age, sex, diagnosis and various costs like ICU charge, ventilator charge, diagnostic charge, etc. were noted in previously formed case record form. Data were analysed by Z, x(2) and unpaired t-test.
RESULT
Patients were divided into less than 45 years and more than 45 year age group. They were divided into medical and surgical patients according to their admission in medical or surgical ward. Mortality, Intensive Care Unit (ICU) admission, patients on ventilator were significantly (p<0.05) higher in medical patients. Direct medical cost, ward bed charge, ICU bed charge, ventilator charge and cost of drug therapy per patient were significantly (p<0.05) higher in medical patients while operation theatre and procedural charge were significantly (p<0.05) higher in surgical patients. Cost of fibrinolytics, anticoagulants, cardiovascular drugs were significantly (p<0.05) higher in medical patients. Cost of antimicrobials, proton pump inhibitors (PPIs), antiemetics, analgesics, were significantly (p<0.05) higher in surgical patients.
CONCLUSION
Ward bed charge, ICU bed charge, ventilator charge accounted more than one third cost of direct medical cost in all the patients. Cost of drug therapy was one fourth of direct medical cost. Antimicrobials cost accounted 33% of cost of drug therapy.
背景
药物经济学是一种分析工具，用于了解住院费用及其对医疗保健系统和社会的影响。在印度，除了政府医疗服务外，私营部门在提供医疗保健服务方面也发挥着重要作用。
目的
研究私立医院住院患者的直接医疗费用和药物治疗费用。
材料与方法
在印度西部一个大城市的私立医院进行了一项回顾性研究。从2013年1月1日至2014年12月31日期间随机选取了400例患者的计费记录。在获得医院医务主任许可后，从医院病历中收集数据。在预先制定的病例记录表中记录患者的人口统计学特征（年龄、性别、诊断）以及各种费用，如重症监护病房（ICU）费用、呼吸机费用、诊断费用等。数据采用Z检验、x²检验和非配对t检验进行分析。
结果
患者分为年龄小于45岁和大于45岁的年龄组。根据他们入住内科或外科病房分为内科和外科患者。内科患者的死亡率、重症监护病房（ICU）入住率、使用呼吸机的患者比例显著（p<0.05）更高。内科患者的直接医疗费用、病房床位费、ICU床位费、呼吸机费用和每位患者的药物治疗费用显著（p<0.05）更高，而外科患者的手术室和手术费用显著（p<0.05）更高。内科患者的纤溶药物、抗凝药物、心血管药物费用显著（p<0.05）更高。外科患者的抗菌药物、质子泵抑制剂（PPI）、止吐药、镇痛药费用显著（p<0.05）更高。
结论
病房床位费、ICU床位费、呼吸机费用占所有患者直接医疗费用的三分之一以上。药物治疗费用占直接医疗费用的四分之一。抗菌药物费用占药物治疗费用的33%。
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