密集护理单位死亡率和密集护理人员人员的成本效益:一项日本全国性的观察性研究
Saori Ikumi1,2, Takuya Shiga3,4,5,6, Takuya Ueda2,7
1Department of Anesthesiology and Perioperative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
日本的高强度人员密集护理单位 (ICU) 与低强度人员密集护理单位相比,显示出较低的患者死亡率和更高的成本效益. 这一分析证实了高强度ICU护理的价值.
科学领域:
- 卫生经济学 卫生经济学
- 关键护理医学 关键护理医学
- 医疗保健管理的管理
背景情况:
- 日本根据每日管理费用将重症监护病房 (ICU) 分类为高强度 (ICU1/2) 和低强度 (ICU3/4).
- 尽管收费较高,但ICU1/2尚未经过成本效益分析.
- 本研究涉及ICU1/2与ICU3/4.4的临床结果和成本效益.
研究的目的:
- 评估高强度人员密集护理单位 (ICU1/2) 与低强度人员密集护理单位 (ICU3/4) 的临床结果.
- 为了确定日本ICU1/2与ICU3/4相比的ICU1/2的成本效益.
- 评估ICU1/2.2的增量成本效益比率 (ICER).
主要方法:
- 从2020年4月到2021年3月,利用日本行政数据库进行的回顾性观察研究.
- 患者被分为ICU1/2和ICU3/4组.
- 分析了ICU和住院死亡率,以及ICER (JPY/QALY),其成本效益值为<500万日元/QALY.
主要成果:
- 与ICU3/4组 (n=46,330;分别为4.3%和8.9%) 相比,ICU1/2组 (n=71,412) 的ICU死亡率 (2.6%) 和住院死亡率 (6.1%) 显著降低.
- 对于ICU1/2 (2,249,270日元) 的患者平均成本高于ICU3/4 (1,682,546日元).
- 对ICU1/2的计算ICER为718,659日元/QALY,低于确定的成本效益值.
结论:
- 高强度人员密切护理单位 (ICU1/2) 与低强度单位 (ICU3/4) 相比,患者死亡率降低.
- 在ICU1/2提供的治疗比ICU3/4.4的治疗更具成本效益.
- 这项研究证实了ICU1/2的成本效益,ICER低于500万日元/QALY.
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