Edbrooke D L, Stevens V G, Hibbert C L, Mann A J, Wilson A J
Department of Medical Physics, Royal Hallamshire Hospital, Sheffield, UK.
Intensive Care Med. 1997 Jun;23(6):645-50. doi: 10.1007/s001340050388.
To analyse the patient-related and non-patient-related costs of intensive care using an activity-based costing methodology.
A retrospective cost analysis of 68 patients admitted sequentially over a 10-week period.
The Adult General Intensive Care Unit of the Royal Hallamshire Hospital, Sheffield.
The results showed large variations in the costs obtained for individual patients. The calculation of the costs for the initial period of stay showed a wide variation depending on whether the costs were determined per calendar day or per first 24-h period. Significant correlations of costs between the first 24 h of stay and the admitting Acute Physiology and Chronic Health II score (p < 0.004) and daily costs with the Therapeutic Intervention Scoring System scores (p < 0.0001) were found. The average daily patient-related cost of care was Pounds 592. Overhead costs were calculated at Pounds 560 per patient day, which made the total cost of a day's treatment in intensive care Pounds 1152.
The use of average costs or scoring systems to cost intensive care is limited, as these methods cannot determine actual resource usage in individual patients. The methodology described here allows all the resources used by an individual patient or group of patients to be identified and thus provides a valuable tool for economic evaluations of different treatment modalities.
采用作业成本法分析重症监护中与患者相关和与患者无关的成本。
对10周内连续收治的68例患者进行回顾性成本分析。
谢菲尔德皇家哈勒姆郡医院成人综合重症监护病房。
结果显示，各患者的成本差异很大。住院初期成本的计算结果差异很大，这取决于成本是按日历日还是按首个24小时计算。研究发现，住院首24小时的成本与入院时急性生理学与慢性健康状况评分系统II（APACHE II）评分显著相关（p < 0.004），每日成本与治疗干预评分系统（TISS）评分显著相关（p < 0.0001）。患者护理的平均每日相关成本为592英镑。间接费用计算为每位患者每天560英镑，这使得重症监护一天的治疗总成本为1152英镑。
使用平均成本或评分系统来计算重症监护成本是有限的，因为这些方法无法确定个体患者的实际资源使用情况。本文所述方法能够识别单个患者或一组患者使用的所有资源，因此为不同治疗方式的经济评估提供了一个有价值的工具。
