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疫苗接种对与新冠病毒感染相关的住院费用及病程的影响。

Impact of Vaccination on Cost and Course of Hospitalization Associated with COVID-19 Infection.

作者信息

Somani Selina T, Firestone Rachelle L, Donnelley Monica A, Sanchez Luciano, Hatfield Chad, Fine Jeffrey, Wilson Machelle D, Duby Jeremiah J

机构信息

Department of Pharmacy, University of California Davis Health, Sacramento, California.

Division of Biostatistics, University of California Davis, Sacramento, California.

出版信息

Antimicrob Steward Healthc Epidemiol. 2023 Jan 25;3(1):e19. doi: 10.1017/ash.2022.364. eCollection 2023.

Abstract

OBJECTIVE

Examine the impact of vaccination status on hospital cost and course for patients admitted with COVID-19 infection.

DESIGN

Retrospective cohort study characterizing vaccinated and unvaccinated individuals hospitalized for COVID-19 between April 2021 to January 2022.

SETTING

Large academic medical center.

METHODS

Patients were included if they were greater than 18 years old, fully vaccinated or unvaccinated against COVID-19, and admitted for COVID-19 infection.

PATIENTS

437 consecutively admitted patients for COVID-19 infection met inclusion criteria. Of these, 79 were excluded for unknown or partial vaccination status, transfer from an outside hospital, or multiple COVID-19 related admissions.

RESULTS

Overall, 279 (77.9%) unvaccinated patients compared to 79 (22.1%) vaccinated patients were hospitalized with a diagnosis of COVID-19. Average length of stay was significantly lower in the vaccinated group (6.47 days versus 8.92 days, = 0.03). Vaccinated patients experienced a 70.6% lower risk of ICU admission (OR = 0.29, 95% CI 0.12-0.71, = 0.006). The unadjusted cost of hospitalization was not found to be statistically significant ($119,630 versus $191,146, = 0.06). After adjusting for age and comorbidities, vaccinated patients experienced a 26% lower cost of hospitalization compared to unvaccinated patients ( = 0.004). Unvaccinated patients incurred a significantly higher cost of hospitalization per day ($29,425 vs $13,845 < 0.0001). Unvaccinated patients (n = 118, 42.9%) were more likely than vaccinated patients (n = 16, 20.3%) to require high-flow oxygen or mechanical ventilation (OR = 2.95, 95% CI 1.62-5.38, = 0.0004).

CONCLUSION

Vaccinated patients experienced a lower cost of hospitalization after adjusting for age and comorbidities and shorter length of stay compared to unvaccinated patients admitted for COVID-19.

摘要

目的

研究疫苗接种状况对新冠病毒感染住院患者的住院费用及病程的影响。

设计

回顾性队列研究,对2021年4月至2022年1月期间因新冠病毒感染住院的接种疫苗和未接种疫苗的个体进行特征分析。

地点

大型学术医疗中心。

方法

纳入年龄大于18岁、新冠病毒疫苗接种完全或未接种且因新冠病毒感染入院的患者。

患者

437例因新冠病毒感染连续入院的患者符合纳入标准。其中,79例因疫苗接种状况未知或部分接种、从外院转入或多次因新冠病毒相关入院而被排除。

结果

总体而言,279例(77.9%)未接种疫苗的患者与79例(22.1%)接种疫苗的患者因新冠病毒感染住院。接种疫苗组的平均住院时间显著更短(6.47天对8.92天,P = 0.03)。接种疫苗的患者入住重症监护病房的风险降低70.6%(比值比 = 0.29,95%置信区间0.12 - 0.71,P = 0.006)。未调整的住院费用未发现有统计学显著差异(119,630美元对191,146美元,P = 0.06)。在调整年龄和合并症后,与未接种疫苗的患者相比,接种疫苗的患者住院费用降低26%(P = 0.004)。未接种疫苗的患者每天的住院费用显著更高(29,425美元对13,845美元,P < 0.0001)。未接种疫苗的患者(n = 118,42.9%)比接种疫苗的患者(n = 16,20.3%)更有可能需要高流量吸氧或机械通气(比值比 = 2.95,95%置信区间1.62 - 5.38,P = 0.0004)。

结论

与因新冠病毒感染入院的未接种疫苗的患者相比,接种疫苗的患者在调整年龄和合并症后住院费用更低,住院时间更短。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/844e/9879923/018165c1c62f/S2732494X22003643_fig1.jpg

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