Nutrition Unit, University General Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain.
Nutrition Unit, University General Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
Clin Nutr. 2019 Aug;38(4):1945-1951. doi: 10.1016/j.clnu.2018.06.972. Epub 2018 Jun 28.
BACKGROUND & AIMS: Home parenteral nutrition (HPN) is a lifesaving treatment for people with chronic intestinal failure and its cost has been reported to be very high. The purpose of the present paper was to study the direct healthcare and non-healthcare costs associated with the HPN programme managed by a tertiary hospital.
Observational, retrospective study of all adult patients on HPN from 11.1.2014 to 10.31.2015 treated at Gregorio Marañón University Hospital (Madrid, Spain). An economic evaluation was undertaken to calculate the direct healthcare (HPN provision, outpatient monitoring and management of complications) and non-healthcare costs (transportation process) of the HPN programme. The variables were collected from medical records, the dispensary and the hospital's financial services. The unit costs were taken from official price lists.
Thirty-two patients met the inclusion criteria. Total direct healthcare and non-healthcare costs amounted to €13,363.53 per patient (€124.02 per patient per day). The direct healthcare costs accounted for 98.32% of overall costs, while the non-healthcare costs accounted for the remaining 1.68%. HPN provision accounted for the majority of the costs (74.25%), followed by management of complications (21.85%) and outpatient monitoring (2.23%).
The direct healthcare costs accounted for the majority of HPN expenditure, specifically HPN provision was the category with the highest percentage.
家庭肠外营养（HPN）是治疗慢性肠衰竭患者的救命治疗方法，其费用据报道非常高。本文旨在研究由一家三级医院管理的 HPN 计划相关的直接医疗和非医疗保健成本。
对 2014 年 11 月 1 日至 2015 年 10 月 31 日在马德里 Gregorio Marañón 大学医院接受 HPN 治疗的所有成年患者进行观察性、回顾性研究。进行经济评估以计算 HPN 计划的直接医疗保健（HPN 供应、门诊监测和并发症管理）和非医疗保健成本（运输过程）。变量从病历、药房和医院财务部门收集。单位成本取自官方价格清单。
32 名患者符合纳入标准。每位患者的直接医疗和非医疗保健总成本为 13,363.53 欧元（每位患者每天 124.02 欧元）。直接医疗保健费用占总费用的 98.32%，而非医疗保健费用占 1.68%。HPN 供应占成本的大部分（74.25%），其次是并发症管理（21.85%）和门诊监测（2.23%）。
直接医疗保健费用占 HPN 支出的大部分，特别是 HPN 供应是占比最高的类别。
