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澳大利亚一家教学医院中风单元在改善患者预后方面的成本效益

The Cost-Effectiveness of a Stroke Unit in Providing Enhanced Patient Outcomes in an Australian Teaching Hospital.

作者信息

Zhai Shaun, Gardiner Fergus, Neeman Teresa, Jones Brett, Gawarikar Yash

机构信息

St Vincent's Hospital, Sydney, Australia.

Calvary Hospital, Bruce, Canberra, Australia; Charles Sturt University, Bathurst, Australia.

出版信息

J Stroke Cerebrovasc Dis. 2017 Oct;26(10):2362-2368. doi: 10.1016/j.jstrokecerebrovasdis.2017.05.025. Epub 2017 Jun 13.

Abstract

BACKGROUND

Stroke is one of the leading causes of disability and mortality. Patients who receive organized inpatient care in a stroke unit (SU) have better clinical outcomes. However, evidence on the cost analysis of an SU is lacking. The objective of this study was to assess the performance and analyze the cost-effectiveness of an SU.

METHODS

A retrospective observational study was conducted comparing the acute stroke patient care in a 6-month period before and after the establishment of an acute SU at Calvary Hospital in 2013-2014.

RESULTS

There were 103 patients included in the pre-SU period, as compared to 186 patients in the post-SU period. In the pre- and post-SU groups, 54 and 87 patients, respectively, had ischemic stroke, with significant trends in improved morbidity and mortality in the post-SU group (P = .01). The average length of stay (LOS) for patients was reduced from 9.7 days to 4.6 days in the post-SU group (P = .001). There was a reduction of cost per admission from $6382 Australian dollars (AUD) with conventional ward care as compared to $6061 (AUD) with SU care.

CONCLUSION

This study confirmed that the establishment of an SU not only improves treatment outcomes but also shortens LOS, thereby achieving cost-effectiveness.

摘要

背景

中风是导致残疾和死亡的主要原因之一。在中风单元(SU)接受有组织的住院治疗的患者临床结局更好。然而,缺乏关于中风单元成本分析的证据。本研究的目的是评估中风单元的绩效并分析其成本效益。

方法

进行了一项回顾性观察研究,比较了2013 - 2014年加尔各答医院急性中风单元建立前后6个月期间急性中风患者的护理情况。

结果

中风单元建立前纳入103例患者,建立后纳入186例患者。在中风单元建立前和建立后的组中,分别有54例和87例患者患有缺血性中风,中风单元建立后的组在发病率和死亡率改善方面有显著趋势(P = 0.01)。中风单元建立后组患者的平均住院时间(LOS)从9.7天降至4.6天(P = 0.001)。与传统病房护理相比,每次住院费用从6382澳元降至中风单元护理的6061澳元。

结论

本研究证实,中风单元的建立不仅改善了治疗结局,还缩短了住院时间,从而实现了成本效益。

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