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估算美国与癫痫持续状态相关的住院费用。

Estimating the cost of admissions related to convulsive status epilepticus in the United States of America.

机构信息

Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, United States; Department of Child Neurology, Sant Joan de Déu, Universidad de Barcelona, Barcelona, Spain.

Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, United States.

出版信息

Seizure. 2018 Oct;61:186-198. doi: 10.1016/j.seizure.2018.08.015. Epub 2018 Aug 19.

Abstract

PURPOSE

To estimate the cost of admissions related to status epilepticus (SE) in the USA and to evaluate SE mortality.

METHOD

Descriptive retrospective study using national estimates from the KID's Inpatient Database (KID) for children and from the National Inpatient Sample (NIS) for adults for the years 2007-2012, the largest collection of all-payer, encounter-level hospital care data in the United States. The individual observation in this study is hospital admission.

RESULTS

From a population of 186,013,640 admissions, a total of 184,500 admissions were related to SE. The median (p-p) cost of admissions related to SE was $7690 ($3893-$17,247) in the KID 2010-2012, $6529 ($3,370-$14,854) in the KID 2007-2009, $13,874 ($6699-$29,176) in the NIS 2012, $13,313 ($6,483-$28,598) in the NIS 2011, $12,999 ($6,366-$27,505) in the NIS 2010, $11,833 ($5721-$24,657) in the NIS 2009, $11,479 ($5,611-$24,326) in the NIS 2008, and $10,759 ($5493-$22,928) in the NIS 2007. Costs were more than two times higher for super-refractory SE admissions than for refractory SE admissions. Costs stratified by age followed an "U"-shaped distribution with higher costs in admissions of young children and older adults. Mortality ranged from 2.5% to 3% in children and from 12.7% to 14.9% in adults.

CONCLUSIONS

This study estimates the cost of admissions related to SE in the USA to be approximately $7000 in children and $13,000 in adults, and quantifies how costs markedly increase once SE becomes super-refractory.

摘要

目的

评估美国与癫痫持续状态(SE)相关住院治疗的费用,并评估 SE 的死亡率。

方法

采用全国性数据,使用儿童 KID's Inpatient Database (KID) 和成人 National Inpatient Sample (NIS) ,进行描述性回顾性研究,数据时间范围为 2007-2012 年,这是美国最大的全支付、住院级别的医院护理数据集合。本研究中的个体观察值是住院治疗。

结果

在 186,013,640 例住院治疗中,共有 184,500 例与 SE 相关。KID 2010-2012 年 SE 相关住院治疗的中位(p-p)费用为 7690 美元(3893-17247 美元),KID 2007-2009 年为 6529 美元(3370-14854 美元),NIS 2012 年为 13874 美元(6699-29176 美元),NIS 2011 年为 13313 美元(6483-28598 美元),NIS 2010 年为 12999 美元(6366-27505 美元),NIS 2009 年为 11833 美元(5721-24657 美元),NIS 2008 年为 11479 美元(5611-24326 美元),NIS 2007 年为 10759 美元(5493-22928 美元)。超难治性 SE 住院治疗的费用比难治性 SE 住院治疗的费用高出两倍以上。按年龄分层的费用呈“U”形分布,幼儿和老年成年人的费用较高。儿童死亡率为 2.5%至 3%,成年人死亡率为 12.7%至 14.9%。

结论

本研究估计美国与 SE 相关住院治疗的费用在儿童中约为 7000 美元,在成人中约为 13000 美元,并量化了一旦 SE 变为超难治性,费用如何显著增加。

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