Indiana University School of Medicine, Indianapolis, IN.
Indiana University School of Medicine, Indianapolis, IN.
Chest. 2020 Jan;157(1):61-66. doi: 10.1016/j.chest.2019.08.2180. Epub 2019 Sep 5.
Admissions to the ICU related to alcohol, prescription drugs, and illicit drugs are shown to be widespread and costly. In 1993, a study revealed 28% of ICU admissions at Johns Hopkins Hospital were related to substance abuse and accrued 39% of costs. Since then, health-care expenditures have increased, and substance abuse treatment admissions have risen. We conducted a study to provide updated data on ICU utilization and costs related to licit and illicit abuse at a large county hospital in Indianapolis, Indiana.
All admissions to the medical ICU at Eskenazi Hospital from March to October 2017 were reviewed. Demographics, reason for admission, relation to substance abuse and specific substance, ICU and hospital length of stay, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, mortality, insurance status, and hospital charges were collected based on chart review.
A total of 611 admissions generated $74,587,280.35 in charges. A total of 25.7% of admissions related to substance abuse accounted for 23.1% of total charges. Illicit drugs were 13% of total admissions, generating 11% of charges. Alcohol-related admissions were 9.5% of total admissions, generating 7.6% of charges. Prescription drugs were 2.9% of admissions, generating 4.2% of charges. Of the substance abuse admissions, patients were generally men and 40 to 64 years of age, with longer ICU stay, higher APACHE II scores, and higher mortality.
Substance abuse admissions make up almost a one-quarter of resources used by our ICU. Patients tend to be younger and sicker with a higher risk of death. Identifying and accurately describing the landscape of this current health crisis will help us take appropriate action in the future.
与酒精、处方药物和非法药物相关的 ICU 入院治疗情况普遍存在且费用高昂。1993 年，约翰霍普金斯医院的一项研究显示，28%的 ICU 入院治疗与药物滥用有关，占总费用的 39%。此后，医疗保健支出增加，药物滥用治疗入院人数也有所上升。我们进行了一项研究，以提供印第安纳州印第安纳波利斯市一家大型县医院与合法和非法滥用相关的 ICU 利用情况和费用的最新数据。
对 2017 年 3 月至 10 月期间 Eskenazi 医院内科重症监护病房的所有入院患者进行了回顾性分析。根据图表回顾收集了人口统计学数据、入院原因、与药物滥用的关系和具体药物、入住 ICU 和医院的时间、急性生理学和慢性健康评估 II（APACHE II）评分、死亡率、保险状况和住院费用。
共 611 例患者产生了 74587280.35 美元的费用。与药物滥用相关的入院治疗占 25.7%，占总费用的 23.1%。非法药物占总入院人数的 13%，占总费用的 11%。酒精相关的入院人数占总入院人数的 9.5%，占总费用的 7.6%。处方药物占入院人数的 2.9%，占总费用的 4.2%。在药物滥用患者中，患者通常为男性，年龄在 40 岁至 64 岁之间，入住 ICU 的时间更长，APACHE II 评分更高，死亡率更高。
药物滥用患者占我们 ICU 资源的近四分之一。患者往往更年轻，病情更严重，死亡风险更高。确定并准确描述当前这一健康危机的现状，将有助于我们在未来采取适当的行动。
