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[多发伤患者临床治疗的成本分析]

[Cost analysis of clinical treatment of polytrauma patients].

作者信息

Ruchholtz S, Nast-Kolb D, Waydhas C, Stuber R, Lewan U, Schweiberer L

机构信息

Chirurgische Klinik und Poliklinik, Ludwig-Maximilians-Universität München.

出版信息

Chirurg. 1995 Jul;66(7):684-92.

PMID:7671756
Abstract

In order to assess the costs arising from the treatment of polytraumatized patients we analysed the data of 100 prospectively studied multiple trauma patients (ISS 38) calculating all medical expenses during their clinical stay. The average cost per patient in the studied group (n = 100) amounted to 63989.- DM. About 65% of this sum derived from the costs of intensive care, while the expenses for operations covered 19%. The group of primarily deceased patients (n = 25) generated the lowest costs of 8468.- DM (per pat.). The highest costs of 95626.- DM were caused by the treatment of patients (n = 32) that developed one or more complications (organ failure) during their stay in the intensive care unit or died (n = 10) during this therapy (101940.- DM). Since the data concerning medical equipment (i.e. surgical devices, radiological equipment) were not centrally registered in the administration department of our clinic, it was not possible to include these costs into this calculation. Thus the total costs must be presumed higher. A relationship between costs of treatment and injury severity (ISS) appeared in polytrauma only by a cost reduction in early deceased very severely injured patients (ISS > 70). The primary diagnosis (injury pattern and severity) cannot predict the incidence of complications increasing the costs of treatment. In the presented study we did not find a correlation between age and treatment costs.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

为评估多发伤患者的治疗费用,我们分析了100例前瞻性研究的多发伤患者(损伤严重度评分[ISS]为38)的数据,计算了他们住院期间的所有医疗费用。研究组(n = 100)中每位患者的平均费用为63989德国马克。这笔费用的约65%来自重症监护费用,而手术费用占19%。主要死亡患者组(n = 25)产生的费用最低,为8468德国马克(每位患者)。费用最高的是在重症监护病房住院期间出现一种或多种并发症(器官衰竭)的患者(n = 32)或在此治疗期间死亡的患者(n = 10)(101940德国马克),其治疗费用为95626德国马克。由于关于医疗设备(如手术器械、放射设备)的数据未在我们诊所的管理部门集中登记,因此无法将这些费用纳入此计算。因此,总费用肯定更高。多发伤中,仅在早期死亡的极重伤患者(ISS > 70)费用降低的情况下,治疗费用与损伤严重度(ISS)之间才呈现出一种关系。主要诊断(损伤类型和严重度)无法预测会增加治疗费用的并发症发生率。在本研究中,我们未发现年龄与治疗费用之间存在相关性。(摘要截短于250字)

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