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儿科神经性厌食症急性住院治疗:经济评估。

Pediatric acute hospitalization for anorexia nervosa: an economic evaluation.

机构信息

Pediatric Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Child Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

出版信息

Ital J Pediatr. 2024 Feb 27;50(1):33. doi: 10.1186/s13052-024-01605-0.

Abstract

BACKGROUND

Anorexia nervosa (AN) is a psychiatric disorders which may potentially led to a high risk of health medical complications, suicide and self-harming behaviour. Since Covid-19 pandemic onset in March 2020, evidence suggested an increase occurrence of AN. The main aim of the retrospective analysis is to define the cost of hospitalization in the acute phase (HAP) at IRCCS Bambino Gesù Children Hospital, Rome, Italy, over 2 years study. Secondary purposes are defining the main risk factors for a prolonged hospitalization (including age, sex and comorbidities) and the possible influence of Covid-19 pandemic on AN admission and hospital stay.

METHODS

for the purpose of the study, we included children and adolescents aged less than 18 years, admitted to IRCCS Bambino Gesù Children Hospital, Rome, Italy, with a diagnosis of AN. Medical costs were calculated consulting the Lazio Regional Health Service Tariffs. Basing on the date of hospital admission, patients were later divided into two subgroups: subgroup A included patients hospitalized prior than Covid-19 onset (from March 2019 to February 2020) and subgroup B those admitted after (from March 2020 to October 2022).

RESULTS

a total of 260 patients has been included in the study with a median age of 15 years (range 6-18 years). The total health care cost of AN hospitalized patients was of EUR 3,352,333 with a median cost of EUR 11,124 for each admission (range EUR 930 - 45,739) and a median daily cost of EUR 593 (range EUR 557-930). Median cost was higher in case of comorbidities, guarded patients, enteral feeding. A prolonged hospitalization has been documented in subgroup A with a higher economic burden.

CONCLUSIONS

the economic burden of eating disorders is of note. Adequate sanitary policies as well as health economic analyses are required to gain insight into the cost-effectiveness of AN management.

TRIAL REGISTRATION

2526-OPBG-2021.

摘要

背景

神经性厌食症(AN)是一种精神疾病,可能导致健康并发症、自杀和自残行为的风险增加。自 2020 年 3 月新冠肺炎大流行开始以来,有证据表明 AN 的发病率有所上升。回顾性分析的主要目的是确定 2 年研究期间意大利罗马 Bambino Gesù 儿童医院急性住院治疗(HAP)的住院费用。次要目的是确定导致住院时间延长的主要危险因素(包括年龄、性别和合并症),以及新冠肺炎大流行对 AN 入院和住院时间的可能影响。

方法

为了进行这项研究,我们纳入了年龄小于 18 岁的、在意大利罗马 Bambino Gesù 儿童医院诊断为 AN 的儿童和青少年。医疗费用通过咨询拉齐奥地区卫生服务费率来计算。根据入院日期,患者随后被分为两个亚组:亚组 A 包括在新冠肺炎大流行前(2019 年 3 月至 2020 年 2 月)入院的患者,亚组 B 包括在新冠肺炎大流行后(2020 年 3 月至 2022 年 10 月)入院的患者。

结果

共有 260 名患者纳入研究,中位年龄为 15 岁(范围 6-18 岁)。AN 住院患者的总医疗保健费用为 3352333 欧元,每次住院的中位数费用为 11124 欧元(范围为 930-45739 欧元),中位数日费用为 593 欧元(范围为 557-930 欧元)。合并症、监护患者和肠内喂养的中位费用较高。亚组 A 记录了较长的住院时间,经济负担更高。

结论

饮食失调的经济负担值得关注。需要适当的卫生政策和健康经济分析,以深入了解 AN 管理的成本效益。

试验注册

2526-OPBG-2021。

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