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法国社区获得性肺炎相关成本。

Costs associated with community acquired pneumonia in France.

机构信息

ESSEC Business School, Avenue Bernard Hirsch, 95021, Cergy-Pontoise Cedex, France.

CH d'Annecy Genevois, Annecy, France.

出版信息

Eur J Health Econ. 2018 May;19(4):533-544. doi: 10.1007/s10198-017-0900-z. Epub 2017 May 25.

Abstract

OBJECTIVES

Pneumocost is a prospective study that aimed at documenting the costs of the management of patients hospitalized with a pneumococcal pneumonia and the post-discharge costs during a 6-month period in the French context.

METHODS

Billing data were used to document hospital costs. Resource use during the follow-up period was collected through phone interviews at month 1, 3 and 6. Descriptive statistics and multivariate analyses were performed. We used generalized linear models with log-link functions to estimate parameters associated with hospital and follow-up costs of patients.

RESULTS

Five hundred twenty-four patients were enrolled in 40 public centers from October 2011 to April 2014. Average age was 63 (SD 17); 55.0% of them were male. Average length of stay was 15 days (SD 23). Average cost of stay for the French Sickness Fund was €7293 (SD €7363). Average cost of follow-up was €1242 (SD €3000) and decreased steadily through time. When controlling for patient's socioeconomic characteristics, severity of disease and hospital stay, results showed a concave relationship between hospital costs and age. Obesity, the severity of the disease and comorbidities were associated with constantly increasing inpatient costs. Concerning follow-up costs, we found the same concave relationship with age, while gender, a history of pneumonia and severity of the disease were the most important predictors of high costs after discharge.

CONCLUSION

Pneumocost is the first French study providing a robust estimation of the cost of managing invasive pneumococcal pneumonia in the French context.

摘要

目的

Pneumocost 是一项前瞻性研究,旨在记录法国住院治疗肺炎链球菌性肺炎患者的管理成本,以及 6 个月随访期内的出院后成本。

方法

使用计费数据记录住院费用。通过在第 1、3 和 6 个月的电话访谈收集随访期间的资源使用情况。采用描述性统计和多元分析。我们使用具有对数链接函数的广义线性模型来估计与患者住院和随访费用相关的参数。

结果

2011 年 10 月至 2014 年 4 月,40 家公立中心共纳入 524 例患者。平均年龄为 63(SD 17)岁;55.0%为男性。平均住院时间为 15 天(SD 23)。法国疾病基金的平均住院费用为 7293 欧元(SD 7363)。平均随访费用为 1242 欧元(SD 3000),且随时间稳步下降。在控制患者的社会经济特征、疾病严重程度和住院时间后,结果显示住院费用与年龄之间呈凹性关系。肥胖、疾病严重程度和合并症与住院费用持续增加有关。关于随访费用,我们发现与年龄也存在相同的凹性关系,而性别、肺炎病史和疾病严重程度是出院后费用高的最重要预测因素。

结论

Pneumocost 是第一项在法国背景下提供侵袭性肺炎链球菌性肺炎管理成本的稳健估计的法国研究。

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