使用无创通气治疗新生儿呼吸窘迫综合征的资源利用模式。
Resource utilization patterns using non-invasive ventilation in neonates with respiratory distress syndrome.
机构信息
Division of Neonatology, Department of Pediatrics, Fetal and Neonatal Institute, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
出版信息
J Perinatol. 2018 Jul;38(7):850-856. doi: 10.1038/s41372-018-0122-y. Epub 2018 May 24.
OBJECTIVES
To describe the frequency of non-invasive ventilation (NIV) and endotracheal intubation use in neonates diagnosed with respiratory distress syndrome (RDS); to describe resources utilization (length of stay (LOS), charges, costs) among NIV and intubated RDS groups.
STUDY DESIGN
Retrospective study from the national Kid's Inpatient Database of the Healthcare Cost and Utilization Project, for the years 1997-2012. Propensity scoring and multivariate regression analysis used to describe differences.
RESULTS
A total of 595,254 out of 42,912,090 cases were identified with RDS. There was an increase in NIV use from 6% in 1997 to 17% in 2012. After matching, patients receiving NIV only were associated with shorter LOS: (95%CI) 25 (25.3,25.7) vs. 35 (34.2,34.9) days, decreased costs: ($/1k) 46.1 (45.5,46.8) vs. 65.0 (64.1,66.0), decreased charges: 130.3 (128.6,132.1) vs. 192.1 (189.5,194.6) compared to intubated neonates.
CONCLUSION
There was a three-fold increase in NIV use within the 15-year study period. NIV use was associated with decreased LOS, charges and costs compared to intubated patients.
目的
描述诊断为呼吸窘迫综合征（RDS）的新生儿使用无创通气（NIV）和气管插管的频率；描述 NIV 和插管 RDS 组之间的资源利用情况（住院时间（LOS）、费用、成本）。
研究设计
这是一项来自医疗保健成本和利用项目国家儿童住院数据库的回顾性研究，研究年限为 1997 年至 2012 年。采用倾向评分和多变量回归分析来描述差异。
结果
在 42912090 例中，共有 595254 例被诊断为 RDS。NIV 的使用从 1997 年的 6%增加到 2012 年的 17%。在匹配后，仅接受 NIV 的患者与较短的 LOS 相关：（95%CI）25（25.3，25.7）vs. 35（34.2，34.9）天，降低成本：（/1k）46.1（45.5，46.8）vs. 65.0（64.1，66.0），降低费用：130.3（128.6，132.1）vs. 192.1（189.5，194.6）与插管新生儿相比。
结论
在 15 年的研究期间，NIV 的使用增加了两倍。与插管患者相比，NIV 的使用与 LOS、费用和成本的降低相关。
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