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[儿童非意外性颅脑创伤:三级医院医疗护理的直接经济成本]

[Trauma craneal no accidental en niños: costo económico directo de la atención médica en un hospital de tercer nivel].

作者信息

Loredo-Abdalá Arturo, Casas-Muñoz Abigail, González-Garay Gabriel Alejandro, Ortiz-Hernández Raquel, González-Corona Jessica María, Ramírez-Angoa Leslie Viridiana

机构信息

Coordinación de Estudios Avanzados sobre el Maltrato Infantil y su Prevención, Ciudad de México, México.

Departamento de Metodología de la Investigación, Ciudad de México, México.

出版信息

Gac Med Mex. 2018;154(6):671-680. doi: 10.24875/GMM.18004399.

Abstract

INTRODUCTION

Abusive head trauma (AHT) is an extreme form of physical abuse that is produced by abruptly shaking an infant or toddler.

OBJECTIVE

To describe the direct economic cost of care during hospitalization of 14 children with confirmed diagnosis of AHT in a pediatric hospital.

METHOD

Analysis of the cost of disease in patients with AHT attended to between 2001 and 2010. Partial direct economic cost of medical care (days of hospital stay, laboratory tests and imaging studies, surgical procedures and subspecialist consultations) was calculated adjusting for inflation, with year 2001 taken as base year. Patients were classified in three groups (moderate, severe and fatal AHT). Descriptive and sensitivity analysis was carried out.

RESULTS

Patients with severe AHT generated higher medical care costs ($105,794.88 ± 33,201.91) in comparison with the group of moderate ($37,012.95, ± 7,154.87) and fatal AHT ($18,595.04 ± 6424.47) (p <0.05). Total cost was $665,467.98 Mexican pesos ($71,249.25 international dollars).

CONCLUSIONS

Total cost for the 14 patients was an elevated figure, as in other parts of the world. The direct economic cost is closely related to the severity of the clinical presentation.

摘要

引言

虐待性头部外伤(AHT)是一种极端的身体虐待形式,由突然摇晃婴儿或幼儿所致。

目的

描述一家儿科医院中14例确诊为AHT的儿童住院期间的直接护理经济成本。

方法

分析2001年至2010年期间接受治疗的AHT患者的疾病成本。计算医疗护理的部分直接经济成本(住院天数、实验室检查和影像学研究、外科手术和专科会诊),并根据通货膨胀进行调整,以2001年为基年。患者分为三组(中度、重度和致命性AHT)。进行描述性和敏感性分析。

结果

与中度AHT组(37,012.95 ± 7,154.87美元)和致命性AHT组(18,595.04 ± 6,424.47美元)相比,重度AHT患者产生的医疗护理成本更高(105,794.88 ± 33,201.91美元)(p <0.05)。总成本为665,467.98墨西哥比索(71,249.25国际美元)。

结论

与世界其他地区一样,这14例患者的总成本很高。直接经济成本与临床表现的严重程度密切相关。

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