冠状动脉手术后深胸部伤口感染的财务影响:微成本分析
Bianca Maria Maglia Orlandi1, Omar Asdrúbal Vilca Mejia1,2, Evelinda Marramon Trindade3
1Department of Cardiovascular Surgery, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, São Paulo, Brazil.
Brazilian journal of cardiovascular surgery
|August 4, 2023
概括
冠状动脉旁路移植后的深胸部伤口感染显著增加了医疗保健成本. 住院成为主要的成本驱动因素,突出了优化患者管理和出院规划的必要性,以减少经济负担.
科学领域:
- 心血管外科心血管外科
- 卫生经济学 卫生经济学
- 预防传染病 预防传染病
背景情况:
- 冠状动脉旁路移植 (CABG) 后的深胸部伤口感染 (DSWI) 对医疗保健系统构成重大财务负担.
- 准确的经济评估,如微成本,对于了解与DSWI相关的真正成本至关重要.
- 有限的研究已经应用了微投资来评估DSWI成本,特别是在单独的CABG之后.
研究的目的:
- 评估与DSWI相关的附加风险调整成本,使用微投注方法对接受隔离CABG的患者进行DSWI.
- 确定导致感染CABG患者费用增加的主要成本驱动因素.
主要方法:
- 一个回顾性,单中心观察队列研究,利用倾向性得分匹配来比较感染和非感染的患者群体.
- 数据来源于REPLICCAR II多中心数据库和Si3电子医院系统.
- 调整了通货膨胀和货币波动;统计分析包括ANOVA和多重线性回归来确定成本驱动因素.
主要成果:
- 深胸部伤口感染导致成本大幅增加:深部感染152%,中炎188%.
- 在感染和非感染群体之间的住院,检查,药物和多学科劳动之间观察到成本的显著差异.
- 住院时间被确定为最关键的成本驱动因素.
结论:
- 这个微成本评估量化了巴西圣保罗CABG患者DSWI的增量成本.
- 住院是影响DSWI总体成本的关键因素,强调需要有效的患者管理.
- 有效的风险评估和管理策略对于促进及时和安全的患者出院至关重要,从而减轻经济影响.
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