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外周置入中心静脉导管在儿科患者中的成本分析。

COST ANALYSIS OF PERIPHERALLY INSERTED CENTRAL CATHETER IN PEDIATRIC PATIENTS.

机构信息

Institute of Health Policy,Management and Evaluation.

Department of Diagnostic Imaging.

出版信息

Int J Technol Assess Health Care. 2018 Jan;34(1):38-45. doi: 10.1017/S026646231700109X. Epub 2017 Dec 20.

DOI:10.1017/S026646231700109X
PMID:29258628
Abstract

PURPOSE

A peripherally inserted central catheter (PICC) is a useful option in providing secure venous access, which enables patients to be discharged earlier with the provision of home care. The objective was to identify the costs associated with having a PICC from a societal perspective, and to identify factors that are associated with total PICC costs.

METHODS

Data were obtained from a retrospective cohort of 469 hospitalized pediatric patients with PICCs inserted. Both direct and indirect costs were estimated from a societal perspective. Insertion costs, complication costs, nurse and physician assessment costs, inpatient ward costs, catheter removal costs, home care costs, travel costs, and the cost associated with productivity losses incurred by parents were included in this study.

RESULTS

Based on catheter dwell time, the median total cost associated with a PICC per patient per day (including inpatient hospital costs) was $3,133.5 ($2,210.7-$9,627.0) in 2017 Canadian dollars ($1.00USD = $1.25CAD in 2017). The adjusted mean cost per patient per day was $2,648.2 ($2,402.4-$2,920.4). Excluding inpatient ward costs, the median total and adjusted costs per patient per day were $198.8 ($91.8-$2,475.8) and $362.7($341.0-$386.0), respectively. Younger age, occurrence of complications, more catheter dwell days, wards with more intensive care, and the absence of home care were significant factors associated with higher total PICC costs.

CONCLUSIONS

This study has demonstrated the costs associated with PICCs. This information may be helpful for healthcare providers to understand PICC related cost in children and resource implications.

摘要

目的

外周静脉置入中心静脉导管(PICC)是提供安全静脉通路的有效选择,使患者能够在提供家庭护理的情况下更早出院。目的是从社会角度确定与 PICC 相关的成本,并确定与 PICC 总成本相关的因素。

方法

数据来自 469 例住院接受 PICC 置管的儿科患者的回顾性队列。从社会角度估计了直接和间接成本。本研究包括置管成本、并发症成本、护士和医生评估成本、住院病房成本、导管移除成本、家庭护理成本、旅行成本以及父母因生产力损失而产生的成本。

结果

基于导管留置时间,每位患者每天(包括住院医院成本)与 PICC 相关的中位总费用为 2017 加元 3133.5 美元(1.00 美元= 2017 年 1.25 加元)。每位患者每天的调整平均费用为 2648.2 美元(2402.4-2920.4)。不包括住院病房费用,每位患者每天的中位总费用和调整费用分别为 198.8 美元(91.8-2475.8)和 362.7 美元(341.0-386.0)。年龄较小、发生并发症、导管留置时间较长、入住更重症监护病房以及没有家庭护理是与 PICC 总费用较高相关的重要因素。

结论

本研究表明了与 PICC 相关的成本。这些信息可能有助于医疗保健提供者了解儿童 PICC 相关成本和资源影响。

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