Keon W J, Menzies S C, Lay C M
Can J Surg. 1985 May;28(3):283-6.
The increasing concern about the high cost of health care led the authors to conduct a pilot study on the overall cost and cost variability for patients who underwent coronary artery bypass grafting. They reviewed the charts of 50 randomly selected patients to determine actual costs of catheterization and bypass grafting. Four patients had single-vessel disease, 12 double- and 34 triple-vessel disease and 13 had moderate to severe impairment of ventricular function. The length of hospital stay ranged from 8 to 43 days (mean 16.5 days). The duration of stay in the recovery room and intensive care unit ranged from 21 to 356 hours (mean 91.6 hours). Operative time ranged from 2 to 6.5 hours (mean 3.95 hours). Using several accepted cost-allocation methods, the authors developed a valid, complete breakdown of clinical and nonclinical costs. Total cost was directly related to the length of hospital stay, left ventricular function, secondary diagnosis and number of diseased vessels. Further studies will address clinical factors related to cost and cost effectiveness of coronary artery bypass grafting as opposed to other forms of treatment for coronary artery disease.
对医疗保健高昂成本的日益关注促使作者对接受冠状动脉搭桥手术的患者的总体成本和成本变异性进行了一项试点研究。他们查阅了50例随机选取患者的病历,以确定导管插入术和搭桥手术的实际成本。4例患者为单支血管病变,12例为双支血管病变,34例为三支血管病变,13例存在中度至重度心室功能损害。住院时间为8至43天(平均16.5天)。在恢复室和重症监护病房的停留时间为21至356小时(平均91.6小时)。手术时间为2至6.5小时(平均3.95小时)。作者使用几种公认的成本分配方法,对临床和非临床成本进行了有效的详细分类。总成本与住院时间、左心室功能、二级诊断和病变血管数量直接相关。与冠状动脉疾病的其他治疗形式相比,进一步的研究将探讨与冠状动脉搭桥手术的成本和成本效益相关的临床因素。