Phillips M S, Bradham D D, Williams R B, Petry M L
Am J Hosp Pharm. 1986 Mar;43(3):676-81.
A multiple-regression model that used hospital data for a single diagnosis-related group (DRG) was developed and tested as a tool for measuring the effect of pharmaceutical services on costs. Computer-generated data from one university teaching hospital for fiscal year 1983 were used to develop a model for identifying patient-specific and treatment-specific factors that correlated with total hospital costs and adjusted total costs (total costs minus room and board). Costs were analyzed for patients hospitalized for cardiothoracic procedures (DRG 108). Data for 100 patients were included. The demographic, severity, treatment-intensity, and drug-use factors included in the model accounted for 95.6% of the variation in adjusted total cost. Length of stay, number of secondary surgical procedures, quantity of supplies or drugs used in the operating room, and several drug therapies--tobramycin, i.v. electrolytes, and i.v. fluids--had significant effects on adjusted total cost. This regression model was useful for assessing the effects of the choice of drug therapy or specific services on the costs for one DRG; it should be tested for other DRGs in other institutions. The usefulness of the model for planning cost-effective services is limited by the need for better billing information, cost-estimation techniques, and records of clinical services provided.
开发并测试了一个多元回归模型，该模型使用单一诊断相关组（DRG）的医院数据作为衡量药学服务对成本影响的工具。利用一所大学教学医院1983财年计算机生成的数据，开发了一个模型，用于识别与医院总成本和调整后总成本（总成本减去食宿费用）相关的患者特异性和治疗特异性因素。对因心胸手术住院的患者（DRG 108）的成本进行了分析。纳入了100名患者的数据。模型中包含的人口统计学、严重程度、治疗强度和药物使用因素占调整后总成本变化的95.6%。住院时间、二次手术数量、手术室使用的耗材或药物数量以及几种药物治疗（妥布霉素、静脉电解质和静脉输液）对调整后总成本有显著影响。该回归模型有助于评估药物治疗选择或特定服务对一个DRG成本的影响；应在其他机构对其他DRG进行测试。由于需要更好的计费信息、成本估算技术和所提供临床服务的记录，该模型在规划具有成本效益的服务方面的实用性受到限制。
