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美国动脉瘤性蛛网膜下腔出血的住院费用。

Cost of hospitalization for aneurysmal subarachnoid hemorrhage in the United States.

作者信息

Modi Sumul, Shah Kavit, Schultz Lonni, Tahir Rizwan, Affan Muhammad, Varelas Panayiotis

机构信息

Department of Neurology, Henry Ford Macomb Hospital, 15855 19 Mile Road, Clinton Township, MI, 48038, United States.

Department of Neurology, University of Pittsburgh Medical Center, 811 Kaufmann Medical Building, 3471 Fifth Avenue, Pittsburgh, PA, 15213, United States.

出版信息

Clin Neurol Neurosurg. 2019 Jul;182:167-170. doi: 10.1016/j.clineuro.2019.05.018. Epub 2019 May 20.

DOI:10.1016/j.clineuro.2019.05.018
PMID:31151045
Abstract

OBJECTIVE

Recent large-scale studies describing hospitalization cost trends secondary to aneurysmal subarachnoid hemorrhage (aSAH) in the United States are lacking. We sought to discover the impact of aSAH-related factors upon its hospitalization cost.

PATIENTS AND METHODS

Patients with a primary diagnosis of aSAH were selected utilizing the National Inpatient Sample. Regression analyses were used to evaluate the impact of aSAH-related factors on hospitalization costs.

RESULTS

From 2002-2014, 22,831 cases of aSAH were identified. The inflation-adjusted mean cost of hospitalization was $82,514 (standard deviation ± $54,983). The proportion of males was lower (31%), but a higher cost of $3385 (± $685; p < .001) remained compared to females. Median length of hospitalization was 16 days (interquartile range 11-23) and each day increase in hospitalization was associated with a cost increase of $3228 (± $19; p < .001). There was no difference in cost between patients undergoing aneurysmal coiling or clipping. When compared to patients < 40 years old, the increase in cost for patients 40-59 years old was $3829 (± $914; p < .001), and $4573 (± $1033; p < .001) for patients 60-79 years old; however, for patients ≥ 80 years old, there was a decrease in cost of $8124 (± $1722; p < .001). Several central nervous system complications were also associated with increased cost.

CONCLUSION

aSAH is a significant financial burden on the United States healthcare system. We were able to identify many important factors associated with higher costs, and these results may help us understand resource utilization and develop future cost-reduction strategies.

摘要

目的

美国目前缺乏描述继发于动脉瘤性蛛网膜下腔出血(aSAH)的住院费用趋势的大规模研究。我们试图探究与aSAH相关的因素对其住院费用的影响。

患者与方法

利用全国住院患者样本选择原发性诊断为aSAH的患者。采用回归分析来评估与aSAH相关的因素对住院费用的影响。

结果

2002年至2014年期间,共识别出22,831例aSAH病例。经通胀调整后的平均住院费用为82,514美元(标准差±54,983美元)。男性比例较低(31%),但与女性相比,男性住院费用仍高出3385美元(±685美元;p < 0.001)。住院时间中位数为16天(四分位间距为11 - 23天),住院时间每增加一天,费用增加3228美元(±19美元;p < 0.001)。接受动脉瘤栓塞或夹闭治疗的患者费用无差异。与40岁以下患者相比,40 - 59岁患者费用增加3829美元(±914美元;p < 0.001),60 - 79岁患者费用增加4573美元(±1033美元;p < 0.001);然而,80岁及以上患者费用减少8124美元(±1722美元;p < 0.001)。几种中枢神经系统并发症也与费用增加相关。

结论

aSAH给美国医疗保健系统带来了沉重的经济负担。我们能够识别出许多与较高费用相关的重要因素,这些结果可能有助于我们了解资源利用情况并制定未来的成本降低策略。

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