急性呼吸窘迫综合征的成本：一项系统评价。

The Cost of ARDS: A Systematic Review.

作者信息

Boucher Paul E, Taplin John, Clement Fiona

机构信息

Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

出版信息

Chest. 2022 Mar;161(3):684-696. doi: 10.1016/j.chest.2021.08.057. Epub 2021 Aug 31.

DOI:10.1016/j.chest.2021.08.057

PMID:34478719

Abstract

BACKGROUND

ARDS is an inflammatory condition of the lungs and is a common condition in adult ICUs. The resources required and costs of care for patients with ARDS are significant because of the severity of the illness and extended ICU lengths of stay.

RESEARCH QUESTION

What are the costs associated with ARDS?

STUDY DESIGN AND METHODS

We systematically searched the literature through April 29, 2021, for articles relevant to ARDS and costs. MEDLINE, Embase, Central, and EconLit databases were searched, and articles that reported on cost data from an original publication in adult patients with ARDS were included. Two authors independently assessed articles for inclusion and extracted data elements related to costs, methodology, health care system type, economic perspective, and clinical data. Publication quality was assessed using a modified version of the Quality of Health Economic Studies Instrument.

RESULTS

Four thousand six hundred sixty-three publications were found, of which 110 were included for full-text review (κ = 0.72). A total of 22 publications (49,483 patients) were suitable for data extraction. The publications represented a broad range of health care systems, economic perspectives, costing methodology, and time frames. Mean inpatient costs ranged from $8,476 (2021 US dollars [USD]) to $547,974 (2021 USD) and were highest in publications of lower quality and in American health systems and were associated with trauma cohorts. Outpatient costs were highest in publications with higher readmission rates, longer durations of follow-up, and in American health systems.

INTERPRETATION

A wide range of costing data is available for ARDS. A comprehensive synthesis of this literature frames the reasons for this and allows estimates to reflect the context in which they were assessed. This information will be of value to researchers and administrators interested in the economics of caring for patients with ARDS.

TRIAL REGISTRY

PROSPERO; No.: CRD42020192487 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=192487.

摘要

背景

急性呼吸窘迫综合征（ARDS）是一种肺部炎症性疾病，在成人重症监护病房（ICU）中很常见。由于病情严重以及ICU住院时间延长，ARDS患者所需的资源和护理成本很高。

研究问题

与ARDS相关的成本有哪些？

研究设计与方法

我们系统检索了截至2021年4月29日的文献，以查找与ARDS和成本相关的文章。检索了MEDLINE、Embase、Central和EconLit数据库，并纳入了报告成人ARDS患者原始研究成本数据的文章。两位作者独立评估文章是否纳入，并提取与成本、方法、医疗保健系统类型、经济视角和临床数据相关的数据元素。使用健康经济研究质量工具的修改版评估出版物质量。

结果

共找到4663篇出版物，其中110篇纳入全文审查（κ = 0.72）。共有22篇出版物（49483例患者）适合进行数据提取。这些出版物代表了广泛的医疗保健系统、经济视角、成本核算方法和时间框架。平均住院成本从8476美元（2021年美元）到547974美元（2021年美元）不等，在质量较低的出版物以及美国医疗系统中最高，并且与创伤队列相关。门诊成本在再入院率较高、随访时间较长的出版物以及美国医疗系统中最高。