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物理治疗服务的可及性与 ICU 成本之间的关系。

Relationship between availability of physiotherapy services and ICU costs.

机构信息

. Hospital do Servidor Público Estadual de São Paulo, São Paulo (SP) Brasil.

. Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil.

出版信息

J Bras Pneumol. 2018 May-Jun;44(3):184-189. doi: 10.1590/S1806-37562017000000196.

Abstract

OBJECTIVE

To determine whether 24-h availability of physiotherapy services decreases ICU costs in comparison with the standard 12 h/day availability among patients admitted to the ICU for the first time.

METHODS

This was an observational prevalence study involving 815 patients ≥ 18 years of age who had been on invasive mechanical ventilation (IMV) for ≥ 24 h and were discharged from an ICU to a ward at a tertiary teaching hospital in Brazil. The patients were divided into two groups according to h/day availability of physiotherapy services in the ICU: 24 h (PT-24; n = 332); and 12 h (PT-12; n = 483). The data collected included the reasons for hospital and ICU admissions; Acute Physiology and Chronic Health Evaluation II (APACHE II) score; IMV duration, ICU length of stay (ICU-LOS); and Omega score.

RESULTS

The severity of illness was similar in both groups. Round-the-clock availability of physiotherapy services was associated with shorter IMV durations and ICU-LOS, as well as with lower total, medical, and staff costs, in comparison with the standard 12 h/day availability.

CONCLUSIONS

In the population studied, total costs and staff costs were lower in the PT-24 group than in the PT-12 group. The h/day availability of physiotherapy services was found to be a significant predictor of ICU costs.

摘要

目的

与 ICU 中首次接受治疗的患者每日接受 12 小时物理治疗服务的标准相比,确定 24 小时提供物理治疗服务是否会降低 ICU 成本。

方法

这是一项观察性流行率研究,共纳入 815 名年龄≥18 岁、接受有创机械通气(IMV)≥24 小时且从 ICU 转至巴西一家三级教学医院普通病房的患者。根据 ICU 中物理治疗服务的 h/天可用性,将患者分为两组:24 小时(PT-24;n=332)和 12 小时(PT-12;n=483)。收集的数据包括入院和入住 ICU 的原因;急性生理学和慢性健康评估 II (APACHE II)评分;IMV 持续时间、ICU 住院时间(ICU-LOS)和 Omega 评分。

结果

两组患者的疾病严重程度相似。与标准的 12 小时/天可用性相比,24 小时物理治疗服务的可用性与更短的 IMV 持续时间和 ICU-LOS 以及更低的总费用、医疗费用和人员费用相关。

结论

在研究人群中,PT-24 组的总费用和人员费用均低于 PT-12 组。物理治疗服务的 h/天可用性是 ICU 成本的一个显著预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/940f/6188682/1e8b12238781/1806-3713-jbpneu-44-03-00184-gf1.jpg

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