相关实验视频
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Mechanical Ventilation Boot Camp Curriculum
Published on: March 12, 2018
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呼吸机相关事件 收到机械通风的ICU患者的成本:一个多状态模型
Alkmena Kafazi1, Eleni Apostolopoulou1, Vasiliki Benetou2
1Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece.
概括
呼吸机相关事件 (VAE) 显著增加了重症监护室 (ICU) 的成本. 使用多状态模型 (MSM) 准确估计每次VAE事件的额外成本,防止过度估计费用.
科学领域:
- 医疗保健经济学 医疗经济学
- 关键护理医学 关键护理医学
- 流行病学 流行病学
背景情况:
- 由于危险因素的时间,医院获得感染的成本分析是复杂的.
- 多状态模型 (MSM) 对于准确评估时间依赖的暴露,如ICU中的感染至关重要.
研究的目的:
- 估计在重症监护室 (ICU) 患者中与呼吸机相关事件 (VAE) 相关的直接额外成本.
- 通过将风险时间和VAE作为时间依赖的风险计算来完善成本估计.
主要方法:
- 一项前性观察性研究在两年内在四个医疗外科ICU中进行.
- 需要机械通风4天以上的成年患者使用CDC对VAE的标准定义进行了跟踪.
- 使用四个州模型估计VAE可归因的额外停留时间 (LOS),直接医院费用用用微成本计算.
主要成果:
- 在378名患者中,143人患有VAE,导致143次发作.
- 经MSM调整后,每次VAE事件的平均额外LOS为6.55±1.78天,明显低于原始估计的17天.
- 每个VAE事件的直接额外成本计算为3,227.84欧元,在研究期间的总直接额外成本为461,581.12欧元.
结论:
- 准确的VAE成本估计需要微成本计算来进行详细的成本分配.
- 多州模型 (MSM) 对于防止高估VAE额外逗留时间和相关成本至关重要.
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