Elpern E H, Behner K G, Klontz B, Warren W H, Szidon J P, Kesten S
Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL, USA.
Chest. 1998 Apr;113(4):896-9. doi: 10.1378/chest.113.4.896.
Lung volume reduction surgery (LVRS) represents a potential breakthrough in the management of advanced emphysema, although questions remain about clinical and economic implications of widespread application of LVRS. In this report, we describe hospital costs, excluding physicians' fees, for LVRS.
Hospital charges were obtained from billing records and converted to costs by applying multiple cost-to-charge ratios.
A large, urban academic medical center.
Fifty-two consecutive patients who received bilateral LVRS through a median sternotomy between April 1995 and August 1996.
Median hospital stay was 10 days (mean= 14.8+/-12.8 days; range=3 to 48 days), including 2 days (mean=6+/-9.2 days; range=1 to 35 days) in the ICU. One hospital death occurred. Hospital costs per case ranged from $11,712 to $121,829, with mean costs of $30,976 and median costs of $19,771. Costs were related significantly to duration of ICU stay and length of hospitalization. Patients who accrued the highest costs were significantly older than the remainder of the sample (69.3 years vs 62.4 years).
Hospital costs of LVRS vary significantly but are related directly to hospital stay. Identification of factors associated with prolonged stays can be used in assessing benefits and risks of LVRS against utilization of health-care dollars.
肺减容手术（LVRS）是晚期肺气肿治疗中的一项潜在突破，尽管对于LVRS广泛应用的临床和经济影响仍存在疑问。在本报告中，我们描述了LVRS的医院成本（不包括医生费用）。
从计费记录中获取医院收费，并通过应用多个成本与收费比率将其转换为成本。
一家大型城市学术医疗中心。
1995年4月至1996年8月期间通过正中胸骨切开术接受双侧LVRS的52例连续患者。
中位住院时间为10天（平均 = 14.8±12.8天；范围 = 3至48天），其中在重症监护病房（ICU）的时间为2天（平均 = 6±9.2天；范围 = 1至35天）。发生了1例医院死亡。每例的医院成本从11,712美元到121,829美元不等，平均成本为30,976美元，中位成本为19,771美元。成本与ICU住院时间和住院时长显著相关。成本最高的患者比其余样本显著年龄更大（69.3岁对62.4岁）。
LVRS的医院成本差异显著，但与住院时间直接相关。识别与延长住院时间相关的因素可用于评估LVRS相对于医疗保健费用使用的益处和风险。
