Michel B C, Seerden R J, van Beek E J, Büller H R, Rutten F F
Erasmus Universiteit, Instituut voor Medische Technology Assessment, Rotterdam.
Ned Tijdschr Geneeskd. 1996 Sep 14;140(37):1864-8.
To compare the costs of diagnosis and treatment of patients clinically suspected of pulmonary embolism, before and after the adoption of the Dutch consensus for the diagnosis of pulmonary embolism.
Study of the records, followed by a prospective study with a follow-up lasting 6 months.
Academic Medical Centre and Slotervaart Hospital, Amsterdam, the Netherlands.
Data were collected on 120 patients from the preconsensus period and on 452 patients examined according to the consensus strategy. This established the average patterns of medical consumption of patients before and after adoption of consensus. The mean costs per patient were then estimated.
Diagnosis and treatment of a patient according to the consensus strategy on the basis of our estimates were considerably less expensive than non-protocolled diagnosis and treatment (Dfl. 4,413 as against Dfl. 5,115 per patient). This difference mainly resulted from shorter hospital stays owing to more rapid completion of the diagnosis. Considering the large number of annual hospital admissions in the Netherlands in connection with this diagnosis, savings of up to Dfl. 26 million would appear possible if the consensus were followed nationwide.
Considerable amounts are involved in the diagnosis and treatment of pulmonary embolism in the Netherlands. Accordingly, further research into possibilities to make these more efficient would appear advisable.
比较采用荷兰肺栓塞诊断共识前后，临床疑似肺栓塞患者的诊断和治疗费用。
记录研究，随后进行为期6个月的前瞻性研究。
荷兰阿姆斯特丹学术医疗中心和斯洛特韦尔特医院。
收集了120例共识前时期患者的数据以及452例根据共识策略检查的患者的数据。这确立了采用共识前后患者的医疗消费平均模式。然后估算了每位患者的平均费用。
根据我们的估算，按照共识策略对患者进行诊断和治疗的费用比无规范的诊断和治疗要低得多（每位患者分别为4413荷兰盾和5115荷兰盾）。这种差异主要是由于诊断更快完成，住院时间缩短所致。考虑到荷兰每年因该诊断的大量住院人数，如果在全国遵循该共识，节省高达2600万荷兰盾似乎是可能的。
荷兰肺栓塞的诊断和治疗涉及大量费用。因此，对提高这些效率的可能性进行进一步研究似乎是可取的。
