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败血症后的高成本用户:基于人口的观察队列研究
Kali A Barrett1,2,3,4, Fatima Sheikh5, Victoria Chechulina6
1Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. kali.barrett@uhn.ca.
Critical care (London, England)
|October 21, 2024
概括
败血症幸存者更有可能成为医疗保健系统的高成本用户 (HCU),在出院后承担更高的成本. 这凸显了败血症在初次住院后的长期经济影响.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 高成本用户 (HCU) 是卫生政策的重点,因为医疗保健支出很大.
- 败血症是一种严重的疾病,与高发病率,死亡率和医疗保健系统的大量经济负担有关.
研究的目的:
- 为了确定败血症对个人在出院后成为下一个高成本用户的可能性的影响.
- 量化血症幸存者中作为高成本用户所花费的随访时间的比例.
主要方法:
- 在加拿大安大略省使用链接的卫生行政数据库进行了基于人口的,倾向性得分加权的队列研究.
- 包括2016年1月至2017年12月期间住院的成年人,他们幸存下来,通过验证的算法确定了败血症.
- 评估的主要结果是持续的高成本用户身份 (连续90天的医疗保健支出前5%或1%) 和医疗保健中心出院后的时间.
主要成果:
- 败血症幸存者很可能处于前5%的HCU组 (OR 2.24) 中,并且在随访时间中花费了更多的时间作为HCU (42.3%与28.9%相比).
- 败血症患者也有更高的可能性在前1%的HCU组 (或2.05) 和花费更多的时间在这个最高的支出类别 (18.5%对10.8%).
结论:
- 败血症的长期后果有助于增加医疗保健成本,产生重大经济影响.
- 与非败血症患者相比,败血症幸存者在出院后更有可能成为并继续成为医疗保健服务的高成本用户.
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