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社区获得性肺炎的住院治疗费用及影响这些费用的因素

Hospital Treatment Costs and Factors Affecting These Costs in Community-Acquired Pneumonia.

作者信息

Akyıl Fatma Tokgöz, Hazar Armağan, Erdem İpek, Öneş Canan Pehlivan, Yalçınsoy Murat, Irmak İlim, Kasapoğlu Umut Sabri

机构信息

Clinic of Chest Diseases, Süreyyapaşa Chest Disease and Chest Surgery Training and Research Hospital, İstanbul, Turkey.

Clinic of Chest Diseases, Dr. Süreyya Adanalı Göksun State Hospital, Kahramanmaraş, Turkey.

出版信息

Turk Thorac J. 2015 Jul;16(3):107-113. doi: 10.5152/ttd.2015.4609. Epub 2015 Jul 1.

Abstract

OBJECTIVES

Community-acquired pneumonia (CAP) accounts for an important part of hospital admissions and health expenses worldwide. The cost increases when treated in a hospital, and reports on this issue are limited in Turkey. This study aimed to investigate direct hospital costs and factors affecting these costs for patients who were hospitalized in our clinic because of the diagnosis of CAP.

MATERIAL AND METHODS

The records of patients who had been hospitalized for the diagnosis of CAP were retrospectively reviewed. Demographic features, radiological features, pneumonia severity index (PSI), CURB-65 scorings, duration of hospitalization, treatments, and the results of treatments were examined. Total hospitalization costs and the expenses for intervention, medication, examinations, and additional services were recorded. The effect of data on the cost was evaluated.

RESULTS

The study was conducted with 87 patients with CAP. The mean duration of hospitalization was 15.6 days and nine patients (10.3%) were exitus. The median total hospital cost was 2062 (451-11690) TL [952 euros (€), 1305 dollars ($)], and the median hospitalization expense per day was 148 Turkish Lira (TL) (68.3 €, 93.7 $). Medication expenses and total cost were higher in male patients than in female patients. Abscess/necrotizing pneumonia increased the cost depending on the infiltration that occurred either alone or with parapneumonic pleurisy. Whereas an increase in the PSI stage increased the total cost and expenses for intervention and medication, medication expenses increased in patients with CURB-65 score of 3 and 4 (p<0.05). Age, smoking, and low oxygen saturation level did not affect the cost. No statistically significant difference was found between the expenses of exitus patients and the expenses of patients who recovered.

CONCLUSION

CAP can lead to high costs and result in death. In our study, it was concluded that the cost increased in male patients, patients with abscess/necrotizing pneumonia, and patients with high PSI scores.

摘要

目的

社区获得性肺炎(CAP)在全球范围内的医院住院病例和医疗费用中占重要部分。在医院接受治疗时费用会增加,而土耳其关于此问题的报告有限。本研究旨在调查因CAP诊断而在我们诊所住院的患者的直接住院费用以及影响这些费用的因素。

材料与方法

回顾性审查因CAP诊断而住院患者的记录。检查人口统计学特征、放射学特征、肺炎严重程度指数(PSI)、CURB - 65评分、住院时间、治疗方法及治疗结果。记录总住院费用以及干预、药物、检查和额外服务的费用。评估数据对费用的影响。

结果

对87例CAP患者进行了研究。平均住院时间为15.6天,9例患者(10.3%)死亡。总住院费用中位数为2062(451 - 11690)土耳其里拉(TL)[952欧元(€),1305美元($)],每日住院费用中位数为148土耳其里拉(TL)(68.3 €,93.7 $)。男性患者的药物费用和总费用高于女性患者。脓肿/坏死性肺炎会根据单独发生或伴有肺炎旁胸膜炎的浸润情况增加费用。而PSI分期增加会使总费用以及干预和药物费用增加,CURB - 65评分为3分和4分的患者药物费用增加(p<0.05)。年龄、吸烟和低氧饱和度水平不影响费用。死亡患者的费用与康复患者的费用之间未发现统计学显著差异。

结论

CAP可导致高额费用并导致死亡。在我们的研究中,得出结论:男性患者、患有脓肿/坏死性肺炎的患者以及PSI评分高的患者费用增加。

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