Dilokthornsakul P, Sawangjit R, Inprasong C, Chunhasewee S, Rattanapan P, Thoopputra T, Chaiyakunapruk N
Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; School of Pharmacy, Monash University Malaysia, Malaysia; School of Population Health, University of Queensland, Brisbane, Australia; School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA, .
J Postgrad Med. 2016 Apr-Jun;62(2):109-14. doi: 10.4103/0022-3859.180571.
Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are life-threatening dermatologic conditions. Although, the incidence of SJS/TEN in Thailand is high, information on cost of care for SJS/TEN is limited. This study aims to estimate healthcare resource utilization and cost of SJS/TEN in Thailand, using hospital perspective.
A retrospective study using an electronic health database from a university-affiliated hospital in Thailand was undertaken. Patients admitted with SJS/TEN from 2002 to 2007 were included. Direct medical cost was estimated by the cost-to-charge ratio. Cost was converted to 2013 value by consumer price index, and converted to $US using 31 Baht/ 1 $US. The healthcare resource utilization was also estimated.
A total of 157 patients were included with average age of 45.3±23.0 years. About 146 patients (93.0%) were diagnosed as SJS and the remaining (7.0%) were diagnosed as TEN. Most of the patients (83.4%) were treated with systemic corticosteroids. Overall, mortality rate was 8.3%, while the average length of stay (LOS) was 10.1±13.2 days. The average cost of managing SJS/TEN for all patients was $1,064±$2,558. The average cost for SJS patients was $1,019±$2,601 while that for TEN patients was $1,660±$1,887.
Healthcare resource utilization and cost of care for SJS/TEN in Thailand were tremendous. The findings are important for policy makers to allocate healthcare resources and develop strategies to prevent SJS/TEN which could decrease length of stay and cost of care.
史蒂文斯 - 约翰逊综合征（SJS）和中毒性表皮坏死松解症（TEN）是危及生命的皮肤病。尽管泰国SJS/TEN的发病率很高，但关于SJS/TEN护理成本的信息有限。本研究旨在从医院角度估计泰国SJS/TEN的医疗资源利用情况和成本。
采用泰国一家大学附属医院的电子健康数据库进行回顾性研究。纳入2002年至2007年因SJS/TEN入院的患者。直接医疗成本通过成本收费比进行估算。成本通过消费价格指数换算为2013年的价值，并以31泰铢/1美元的汇率换算为美元。同时还估算了医疗资源利用情况。
共纳入157例患者，平均年龄为45.3±23.0岁。约146例患者（93.0%）被诊断为SJS，其余（7.0%）被诊断为TEN。大多数患者（83.4%）接受了全身性皮质类固醇治疗。总体死亡率为8.3%，平均住院时间（LOS）为10.1±13.2天。所有患者管理SJS/TEN的平均成本为1,064美元±2,558美元。SJS患者的平均成本为1,019美元±2,601美元，而TEN患者的平均成本为1,660美元±1,887美元。
泰国SJS/TEN的医疗资源利用和护理成本巨大。这些发现对于政策制定者分配医疗资源和制定预防SJS/TEN的策略非常重要，这可以缩短住院时间并降低护理成本。
