儿科ICU镇静断奶协议的成本效益分析
Chiara Velez1, Jessica J Anderson2, J Jackson Resser3
199 MDG (CV) of the United States Air Force at Nellis Air Force Base, NV.
概括
在儿科重症监护室 (PICU) 实施了一项新的镇静断奶方案,显著降低了药物费用,但没有恶化患者的戒断症状. 这证明了在重症儿童中进行镇静管理的成本有效方法.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 药物经济学 药物经济学
- 临床协议实施方案
背景情况:
- 镇静对于儿科重症监护室 (PICU) 中的被直管儿童来说至关重要.
- 从镇静剂中断奶可以是复杂和昂贵的.
- 之前的研究表明,风险分层协议可以改善结果.
研究的目的:
- 评估风险分层镇静断奶协议对PICU药物费用的影响.
- 评估协议是否影响了患者的戒断症状.
主要方法:
- 在儿科重症监护病房 (PICU) 进行的回顾性观察队列研究.
- 在议定书实施之前和之后 (2018-2020年) 取消子二胺,阿尔法激动剂和/或阿片类药物输注的药物成本的比较.
- 分析了在18岁以下的被直管儿童中84例镇静断奶的情况.
主要成果:
- 总的镇静奶费用从协议前的400,328.87美元下降到协议后的170,458.85美元.
- 该方案与每名患者估计的5173.20美元的成本降低有关,调整为体重和药物风险 (p=0.036).
- 在协议前 (16%) 和协议后 (14%) 组中,戒断症状的发生率相似 (p=0.435).
结论:
- 在PICU中实施风险分层镇静断奶协议导致了显著的成本节省.
- 该协议没有对患者的结果产生负面影响,特别是戒断症状.
- 建议进行进一步的多中心研究,以在各种 PICU 设置中验证这些发现.
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