儿童癫痫持续状态的住院医疗费用：来自中国的一项全国性、多中心研究。

Inpatient medical cost of status epilepticus in children: A national-wide, multicenter study from China.

机构信息

Department of Neurology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.

Pediatric Intensive Care Unit, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.

出版信息

Epilepsy Behav. 2021 Oct;123:108248. doi: 10.1016/j.yebeh.2021.108248. Epub 2021 Aug 26.

DOI:10.1016/j.yebeh.2021.108248

PMID:34455296

Abstract

OBJECTIVES

To describe the inpatient medical cost during hospitalization in children with status epilepticus (SE) and identify factors associated with the cost by a nationwide, multicenter study in China.

MATERIALS & METHODS: We retrospectively identified pediatric inpatients with SE form Hospital Information System (HIS) of 44 hospitals in 27 provinces in China between 2013 and 2015. Inpatient medical cost and factors associated with the cost were analyzed.

RESULTS

A total of 4041 children diagnosed with SE with inpatient medical cost were enrolled in the present study. The median age at admission was 2.9 (range 0.1-18) years, and 2271 patients were male (56.2%). The median inpatient medical cost of children with SE was $1175.5 (665.1-2320.6). The median inpatient medical cost was $3865.6 (1837.4-8210.4) in children with SRSE and $1048.6 (619.8-1865.4) in those with N-SRSE (p < 0.0001). Children with length of hospital stay (LOS) > 7 showed a much higher inpatient medical cost than those with LOS ≤ 7 day ($2300.7 vs. $767.2, p < 0.0001). Regarding different etiologies, children with acute symptomatic etiology showed the highest median inpatient medical cost of $1681.1 (901.0-3699.6), in which children with central nervous system (CNS) infection reported $2606.0 (1380.0-5016.1) and prolonged febrile seizures (PFS) reported $909.8 (649.3-1322.0). Additionally, children with idiopathic/cryptogenic etiology reported a medical cost of $923.2 (548.9-1534.5). Multiple linear regression analysis of cost-driving factors revealed LOS > 7, examinations, treatment equipment and procedures, and treatment medicines were independently associated with a higher inpatient medical cost (R = 60.91). In addition, PFS and idiopathic/cryptogenic epilepsy etiology were independently associated with a lower cost.

CONCLUSIONS

SE in children was a cost intensive disease in China with a median inpatient medical cost of $1175.5. LOS, etiology and examinations, treatment equipment and procedures, and treatment medicines were significantly associated with inpatient medical cost.

摘要

目的

通过在中国进行的一项全国性多中心研究，描述癫痫持续状态（SE）住院患儿的住院医疗费用，并确定与费用相关的因素。

材料与方法

我们回顾性地从中国 27 个省的 44 家医院的医院信息系统（HIS）中确定了 2013 年至 2015 年期间患有 SE 的儿科住院患儿。分析了住院医疗费用及与费用相关的因素。

结果

本研究共纳入 4041 例诊断为 SE 的住院患儿，中位入院年龄为 2.9 岁（范围 0.1-18 岁），2271 例为男性（56.2%）。SE 患儿的中位住院医疗费用为 1175.5 美元（665.1-2320.6）。伴有 SRSE 的患儿中位住院医疗费用为 3865.6 美元（1837.4-8210.4），伴有非 SRSE 的患儿中位住院医疗费用为 1048.6 美元（619.8-1865.4）（p＜0.0001）。住院时间（LOS）＞7 天的患儿的住院医疗费用明显高于 LOS≤7 天的患儿（2300.7 美元比 767.2 美元，p＜0.0001）。不同病因中，急性症状性病因患儿的中位住院医疗费用最高，为 1681.1 美元（901.0-3699.6），其中中枢神经系统（CNS）感染患儿为 2606.0 美元（1380.0-5016.1），热性惊厥持续状态（PFS）患儿为 909.8 美元（649.3-1322.0）。特发性/隐源性病因患儿的医疗费用为 923.2 美元（548.9-1534.5）。对费用驱动因素的多元线性回归分析显示，LOS＞7、检查、治疗设备和程序以及治疗药物与较高的住院医疗费用独立相关（R=60.91）。此外，PFS 和特发性/隐源性癫痫病因与较低的费用独立相关。