专科医生在日常临床实践中的成本意识:一个前性的多中心研究
Timothée Lehut1, Céline Lambert2, Romain Mortier2
1Department of Anaesthesiology and Critical Care Medicine, CHU Clermont-Ferrand, Clermont-Ferrand, France.
概括
法国重症监护室 (ICU) 的重症监护医生表现出缺乏成本意识,大大高估了整体成本,尤其是废物成本. 提高对处方,实验室测试和浪费费用的认识,对于具有成本效益的护理至关重要.
科学领域:
- 医疗保健管理的管理
- 医学经济学 医学经济学
- 关键护理医学 关键护理医学
背景情况:
- 在医疗保健中实现最佳的效益/风险/成本比需要提高成本意识.
- 重症监护室 (ICU) 设置具有复杂的成本结构,需要仔细考虑财务因素.
- 评估重症监护医生的成本意识对于改善重症监护的资源配置至关重要.
研究的目的:
- 评估重症医生在日常临床实践中的成本意识.
- 确定影响密集医师成本估计准确性的因素.
- 确定ICU估计和实际每日成本之间的差异.
主要方法:
- 在七个法国ICU进行了前性观察研究.
- 强化治疗师估计的日常护理费用与实际费用进行了比较.
- 估计包括五个类别:药物,实验室测试,成像,医疗器械和废物.
主要成果:
- 在65名重症监护医生的234项成本估计中,只有29.9%是准确的 (实际成本的50-150%).
- 估计成本的中位数 (330欧元) 比实际成本 (178欧元) 高得多,原因是废物过高估计和实验室测试低估.
- 对处方费用的认识与准确估计相关,而对估计能力的信心与负相关.
结论:
- 法国强化治疗师在日常实践中显著缺乏成本意识.
- 改善的关键领域包括提高对处方,实验室测试和废物成本的认识.
- 有针对性的教育干预可以帮助重症监护医生在重症监护中实现更好的成本效益.
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