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美国成人患者中脑膜炎和脑炎的管理成本。

Cost of managing meningitis and encephalitis among adult patients in the United States of America.

机构信息

Department of Pathology, The Ohio State University Wexner Medical Center, OH, USA.

Premier Research Services, Premier Healthcare Solutions Inc., Charlotte, NC, USA.

出版信息

Int J Infect Dis. 2018 Jun;71:117-121. doi: 10.1016/j.ijid.2018.04.799. Epub 2018 Apr 24.

Abstract

OBJECTIVE

To determine the associated costs related to the diagnosis and treatment of meningitis and encephalitis (ME) in adult patients in the USA.

METHODS

A retrospective observational study design was used to assess the use and costs of diagnostic tests and antimicrobial treatment and the total hospitalization costs for adult patients with suspected ME, who received a lumbar puncture procedure during an emergency department visit or during the first two service days of an inpatient stay. Related costs were calculated by timing of lumbar puncture performed and infectious etiology.

RESULTS

A total 26429 adult patients with suspected ME diagnosed between 2011 and 2014 were included in the study. The mean hospitalization cost was $15 572±27168, with antimicrobial medication cost of $1144±4052 and laboratory test cost of $210±244. The total visit cost increased with delayed lumbar puncture procedure, intensive care unit stay, and if the etiology was fungi, arbovirus, or bacteria.

CONCLUSIONS

Higher diagnostic and treatment costs are associated with a delayed lumbar puncture procedure, the etiological agent, and the requirement for an intensive care unit stay.

摘要

目的

确定美国成人脑膜炎和脑炎(ME)诊断和治疗相关的成本。

方法

采用回顾性观察研究设计,评估疑似 ME 成年患者的诊断性检查和抗菌治疗的使用情况和成本,以及总住院费用,这些患者在急诊科就诊期间或住院后前两天内进行了腰椎穿刺。根据腰椎穿刺的时间和感染病因计算相关成本。

结果

研究纳入了 2011 年至 2014 年间确诊的 26429 例疑似 ME 的成年患者。平均住院费用为 15572±27168 美元,抗菌药物费用为 1144±4052 美元,实验室检查费用为 210±244 美元。腰椎穿刺时间延迟、入住重症监护病房以及病因是真菌、虫媒病毒或细菌时,就诊费用会增加。

结论

腰椎穿刺时间延迟、病因和入住重症监护病房会导致更高的诊断和治疗费用。

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