断奶失败的成本:对德国医疗保健系统经济影响的前性,多中心,受控,非随机,干预性研究
Julia D Michels1, Franziska C Trudzinski1, Florian Bornitz2
1Thoraxklinik Heidelberg, Department of Pneumology and Critical Care, Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Heidelberg, Germany.
将需要机械通风的患者转移到专门的断奶中心可以改善结果,并大大降低医疗保健成本. 早期干预为呼吸衰竭患者提供了大幅度的节约和更好的生活质量.
科学领域:
- 关键护理医学 关键护理医学
- 卫生经济学 卫生经济学
- 肺部病理学 肺部病理学
背景情况:
- 患有呼吸衰竭的重症监护室患者经常需要侵入性机械通风 (IMV).
- 越来越多的患者无法从IMV中断奶,往往无法进入专门的断奶中心.
- 这种情况导致生活质量下降和医疗保健支出增加.
研究的目的:
- 评估在初始断奶失败后转移到经认证的断奶中心的患者的断奶成功情况.
- 为了比较断奶中心患者的护理费用与在门诊环境中长期接受IMV患者的护理费用.
主要方法:
- 一项前性,多中心,非随机干预性研究,涉及61名患者转诊至第二次断奶阶段.
- 在断奶中心的患者和接受门诊IMV的对照队列之间的1年成本的比较.
- 使用的保险索赔数据用于门诊患者队列.
主要成果:
- 在断奶中心的82%的患者成功实现了断奶 (完全或部分),而不需要IMV.
- 在断奶中心组中,每个患者的平均成本为114,877.08.8欧元.
- 长期门诊IMV队列的成本为每名患者234,442.62欧元.
结论:
- 早期转移到经过认证的断奶中心可以提高断奶成功率.
- 这一策略使得每名患者的第一年总成本减少约12万欧元.
- 在考虑长期IMV以优化医疗和经济结果之前,应该优先考虑所有患者进入断奶中心.
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