加拿大PICU的早期康复包:在2018-2020年实施的成本分析
Shira Gertsman1,2, Sureka Pavalagantharajah1,3, Lindsey Falk1
1Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
概括
实施ABCDEF包需要大量的资源和人员时间,耗资超过5万加元. 实施后,儿科重症监护室 (PICU) 患者费用没有显著变化.
科学领域:
- 临界护理医学 临界护理医学
- 卫生经济学 卫生经济学
- 儿科康复儿童康复中心
背景情况:
- 儿童重症监护室 (PICU) 的早期康复对于患者的康复至关重要.
- 该ABCDEF捆绑 (觉醒,呼吸,协调,妄想监测/管理,早期流动性和家庭参与) 是早期康复的关键策略.
- 对于医疗保健提供者来说,了解实施这些包的资源影响和成本影响是必不可少的.
研究的目的:
- 确定在PICU中实施ABCDEF捆绑的资源和相关成本.
- 为了比较每位患者的成本,在实施ABCDEF包之前和之后.
主要方法:
- 与2018年至2020年麦克马斯特儿童医院PICU的实施研究一起进行了成本分析.
- 在实施之前和之后计算了资源利用 (人员工作时间,材料成本) 和患者一级成本.
- 使用统计分析,包括线性回归来比较成本,并根据患者因素进行调整.
主要成果:
- 实施涉及907个人员小时,成本为50,813加元,医生贡献的时间最多.
- 材料成本是最小的 (CAD 860).
- 每名患者的PICU调整平均成本在实施后增加了17% (17,342 CAD前 vs. 20,310 CAD后),而药房成本显示非显著下降.
结论:
- 实施ABCDEF捆绑需要大量的时间投资和跨学科的合作.
- 短期内没有观察到对整体PICU或患者成本的重大影响.
- 需要长期研究,包括以患者为中心的结果,以评估ABCDEF捆绑的成本效益.
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