Dasta J F, Armstrong D K
College of Pharmacy, Ohio State University, Columbus 43210.
Drug Intell Clin Pharm. 1988 Dec;22(12):994-8. doi: 10.1177/106002808802201214.
Financial information on 131 patients and drug-related information on 176 patients admitted to a surgical intensive care unit (ICU) were prospectively collected. The average stay was nearly five days and patients received 8.6 drugs per day for a total average exposure of 12.2 different drugs. Antibiotics and analgesics were used in over 90 percent of patients. The patients' diagnoses fit into 53 different diagnosis-related groups (DRG). Hospital costs were significantly greater than DRG payment for an average revenue loss of $17,803 per patient. Patients with a primary diagnosis of sepsis had the largest revenue loss, averaging $54,738. One hundred patients were revenue losers. Total hospital stay was statistically longer than DRG-projected length of stay. Pharmacy charges averaged 13.6 percent of total hospital charges. Patients receiving systemic antifungals, triple antibiotics, catecholamines, and total parenteral nutrition had high hospital and pharmacy costs. This study suggests that ICU patients are costly to hospitals and that drug use is expensive. We suggest that increased pharmacy involvement in the care of ICU patients may help curtail escalating drug costs in these patients.
前瞻性收集了131例入住外科重症监护病房（ICU）患者的财务信息以及176例患者的药物相关信息。平均住院时间近5天，患者每天接受8.6种药物治疗，平均总共接触12.2种不同药物。超过90%的患者使用了抗生素和镇痛药。患者的诊断分为53个不同的诊断相关组（DRG）。医院成本显著高于DRG支付，平均每位患者收入损失17,803美元。以脓毒症为主要诊断的患者收入损失最大，平均为54,738美元。100例患者为收入亏损者。总住院时间在统计学上长于DRG预测的住院时间。药房费用平均占医院总费用的13.6%。接受全身抗真菌药、三联抗生素、儿茶酚胺和全胃肠外营养的患者医院和药房成本较高。这项研究表明，ICU患者对医院来说成本高昂，而且药物使用费用昂贵。我们建议，药房更多地参与ICU患者的护理可能有助于控制这些患者不断攀升的药物成本。
