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重症监护病房(ICU)和非重症监护病房的每日费用。

ICU and non-ICU cost per day.

作者信息

Norris C, Jacobs P, Rapoport J, Hamilton S

机构信息

University of Calgary, Canada.

出版信息

Can J Anaesth. 1995 Mar;42(3):192-6. doi: 10.1007/BF03010674.

Abstract

The purpose of this study was to compare the cost of a day spent in an intensive care unit and a day spent on a general nursing unit. A descriptive design was used, based on patient level data, to examine and compare unit costs per day for each of the ICU and non-ICU portions of a patient's hospital stay. Records from 386 patients who were treated in a general medical/surgical ICU were analyzed. Records for patients who received both ICU and non-ICU care during their stay were retained. Patients were categorized according to whether they had received surgical care prior to admission to the ICU (surgical group) or had no surgical care (medical group). The groups were further divided, based on whether they were discharged from hospital (survivors), or died following transfers from the ICU (non-survivors). All four groups; surgical or medical, survivors and non-survivors, were analyzed separately. The ICU direct costs per day for survivors were between six and seven times those for non-ICU care. A one day substitution of general ward for ICU care would result in a cost reduction of $1,200 per patient for survivors. The results suggest that the savings achieved by moving a patient from ICU to non-ICU care are considerable, particularly for less severe surviving patients. In making such decisions, however, clinicians must examine prospective benefits as well as costs. If the health outcomes are not influenced, the savings from substitution are considerable, and there is a strong economic argument for substitution.

摘要

本研究的目的是比较在重症监护病房(ICU)度过一天的费用与在普通护理病房度过一天的费用。采用了基于患者层面数据的描述性设计,以检查和比较患者住院期间ICU和非ICU部分每天的单位成本。分析了在普通内科/外科ICU接受治疗的386例患者的记录。保留了住院期间同时接受ICU和非ICU护理的患者的记录。患者根据入院前是否接受过手术治疗(手术组)或未接受过手术治疗(内科组)进行分类。根据患者是出院(存活者)还是从ICU转出后死亡(非存活者),将这些组进一步细分。对所有四组,即外科或内科、存活者和非存活者,分别进行分析。存活者在ICU每天的直接费用是非ICU护理费用的六至七倍。对于存活者,将一天的ICU护理替换为普通病房护理,每位患者可节省1200美元。结果表明,将患者从ICU护理转移至非ICU护理可实现可观的费用节省,尤其是对于病情较轻的存活患者。然而,在做出此类决策时,临床医生必须同时考虑预期收益和成本。如果健康结果不受影响,替换带来的节省相当可观,并且从经济角度来看,替换具有充分的理由。

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