儿童肺炎病例的成本 带有或没有胸部X射线图
Alexandra T Geanacopoulos1,2, Mark I Neuman1,2, Kenneth A Michelson3
1Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
Hospital pediatrics
|January 17, 2024
概括
在急诊室 (ED) 的小儿社区获得性肺炎 (CAP) 胸部X射线 (CXR) 是具有成本效益的. 在患有CAP的儿童中使用CXR可以大大节省28天的成本,主要是由于减少了随后的医疗保健访问.
科学领域:
- 儿科急救医学 儿科急救医学
- 卫生经济学 卫生经济学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 社区获得性肺炎 (CAP) 是常见的儿童出现在急诊室 (EDs).
- 常规胸部放射 (CXR) 在儿科ED诊断CAP的成本效益仍然不确定.
- 评估CXR在儿科CAP工作中的经济影响对于资源分配至关重要.
研究的目的:
- 评估使用胸部X射线 (CXR) 在社区获得性肺炎 (CAP) 治疗中从儿科急诊室 (ED) 出院的儿童的成本效益.
- 分析与CAP发作相关的28天总医疗费用,比较具有和没有CXR的医疗费用.
主要方法:
- 使用医疗保健成本和利用项目国家ED和住院患者数据库 (2014-2019) 的回顾性队列研究.
- 包括3个月至18岁的儿童,他们被诊断患有CAP,并从8个州的ED医院出院.
- 分析ED出院后28天的总费用,包括指数访问和随后的护理,使用混合效应线性回归调整为患者因素和疾病严重程度.
主要成果:
- 总共有225,781名患有CAP的儿童被评估;86.2%的儿童在指数ED访问期间接受了CXR.
- 每次病发的28天中位成本为314美元. 与没有CXR (95%CI:$22-$44) 患者相比,接受CXR的患者在28天的总费用中减少了33美元.
- 在随后的医疗保健访问中主要观察到节省 (26美元的节省),而不是指数ED访问 (6美元的节省).
结论:
- 在儿科急诊室 (ED) 诊断社区获得性肺炎 (CAP) 的胸部放射 (CXR) 与较低的整体医疗费用有关.
- CXR的成本效益是由下游医疗保健利用率和后续护理成本的减少所驱动的.
- 儿科CAP评估中的常规CXR可以在考虑整个护理情节时成为节省成本的策略.
更多相关视频
05:50International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
Published on: March 12, 2020
13.6K
06:16Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
428
相关概念视频
Pneumonia III: Complications and Assessment
227
Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
227
Pneumothorax-II
153
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
153
Pneumonia I: Introduction
239
Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
239
Pneumonia IV: Management
331
The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
331
Pulmonary Cycle: Exhalation
1.6K
In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...
1.6K
Pneumonia II: Pathophysiology
278
The pathophysiology of pneumonia involves the following steps:
278
