确定儿科肝移植成本的驱动因素
Divya G Sabapathy1, Kathleen Hosek2, Fong W Lam1
1Department of Pediatrics, Baylor College of Medicine, Division of Critical Care Medicine, Houston, Texas, USA.
概括
儿科肝移植 (LT) 的成本有很大差异,高成本的医院治疗更病的儿童,并承担更高的费用. 了解这些经济驱动因素是改善高价值护理和标准化结果的关键.
科学领域:
- 儿科胃肠病学和肝病学
- 卫生经济学 卫生经济学
- 移植医学 移植医学
背景情况:
- 了解儿科肝移植 (LT) 的经济性对于高价值护理至关重要.
- 在全国范围内,儿科LT的成本存在显著差异.
- 识别成本驱动因素和医院因素对于优化护理至关重要.
研究的目的:
- 在全国范围内检查儿科LT的成本和资源利用情况.
- 确定关键的驱动因素的总护理成本.
- 分析与更高的儿科LT成本相关的医院因素.
主要方法:
- 从儿童健康信息系统中对3295例儿科LT病例 (2010-2020年) 的回顾性审查.
- 患者的分层分为高成本,中成本和低成本的第三方.
- 分析每 LT 的成本,服务线成本,死亡率,并发症和资源利用率.
主要成果:
- 每个儿科LT的中位成本为150,836美元,医院间差异很大.
- 高成本医院管理的患者有更高的疾病严重程度和死亡风险.
- 脏并发症和全肠直肠营养是重要的独立成本贡献者.
结论:
- 儿科LT费用存在显著差异,高成本中心管理更生病的患者.
- 需要进一步的研究来定义儿科LT的价值和标准化护理.
- 有针对性的策略可以改善复杂的儿科LT病例的结果.
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