von der Warth Rieka, Hehn Philip, Wolff Jan, Kaier Klaus
Section of Health Care Research and Rehabilitation Research, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 49, 79106, Freiburg, Germany.
Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany.
Health Econ Rev. 2020 Jul 11;10(1):23. doi: 10.1186/s13561-020-00281-0.
Post-traumatic stress disorder is likely to affect clinical courses in the somatic hospital ward when appearing as comorbidity. Thus, this study aimed to assess the costs associated with comorbid post-traumatic stress disorder in a somatic hospital and to analyze if reimbursement appropriately compensated additional costs.
The study used data from a German university hospital between 2011 and 2014, analyzing 198,819 inpatient episodes. Inpatient's episodes were included for analysis if they had a somatic primary diagnosis and a secondary diagnosis of post-traumatic stress disorder. Costs were calculated based on resource use and compared to reimbursement. Analyses were adjusted for sex, age and somatic comorbidities.
N = 219 Inpatient's episode were found with primary somatic disorder and a comorbid post-traumatic stress disorder. Inpatients episodes with comorbid post-traumatic stress disorder were compared to 34,229 control episodes, which were hospitalized with the same main diagnosis. Post-traumatic stress disorder was associated with additional hospital costs of €2311 [95%CI €1268 - €3355], while reimbursement rose by €1387 [€563 - €2212]. Results indicate that extra costs associated with post-traumatic stress disorder are not fully reimbursed. Male patients showed higher hospital costs associated with post-traumatic stress disorder. On average, post-traumatic stress disorder was associated with an extra length of stay of 3.4 days [2.1-4.6 days].
Costs associated with post-traumatic stress disorder were substantial and exceeded reimbursement, indicating an inadequate reimbursement for somatic patients with comorbid post-traumatic stress disorder.
创伤后应激障碍若作为共病出现,可能会影响综合医院病房的临床病程。因此,本研究旨在评估综合医院中创伤后应激障碍共病的相关费用,并分析报销是否适当补偿了额外费用。
本研究使用了德国一家大学医院2011年至2014年的数据,分析了198,819例住院病例。如果住院病例有躯体原发性诊断和创伤后应激障碍继发性诊断,则纳入分析。根据资源使用情况计算费用,并与报销情况进行比较。分析对性别、年龄和躯体共病进行了调整。
发现有219例住院病例患有原发性躯体疾病和创伤后应激障碍共病。将创伤后应激障碍共病的住院病例与34,229例对照病例进行比较,这些对照病例的主要诊断相同。创伤后应激障碍与额外的住院费用2311欧元相关[95%置信区间1268欧元 - 3355欧元],而报销费用增加了1387欧元[563欧元 - 2212欧元]。结果表明,与创伤后应激障碍相关的额外费用没有得到充分报销。男性患者与创伤后应激障碍相关的住院费用更高。平均而言,创伤后应激障碍与额外住院时间3.4天相关[2.1 - 4.6天]。
与创伤后应激障碍相关的费用很高且超过了报销额度,这表明对患有创伤后应激障碍共病的综合医院患者报销不足。