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在电生理学研究与心电图监测试验 (ESVEM) 中初始治疗的成本
N A Omoigui1, F I Marcus, J W Mason
1Department of Health Research and Policy, Stanford University School of Medicine, CA 94305-5092.
Circulation
|February 15, 1995
概括
与霍尔特监测 (HM) 相比,心室节律失常的电生理学测试 (EPS) 会导致较高的初始医院费用,这是由于更多的药物试验和较低的成功率. 无法找到有效的药物和出现突然死亡也会增加成本.
科学领域:
- 心脏病学 心脏病学
- 卫生经济学 卫生经济学
背景情况:
- 危及生命的心室心律失常需要有效的抗心律失常治疗.
- 在ESVEM研究中,电生理学测试 (EPS) 和Holter监测 (HM) 之间的死亡率和复发率相等,用于指导治疗.
- 本分析调查了EPS与HM在初始患者评估和管理中的成本影响.
研究的目的:
- 分析电生理学测试 (EPS),霍尔特监测 (HM) 和临床因素对危及生命的腹腔失常症患者的初始住院费用的影响.
- 在这个患者群体中确定更高初始医院费用的独立预测因素.
主要方法:
- 分析了参与ESVEM研究的10个临床中心的初始住院费用.
- 在对数转换后进行线性回归分析,以确定电荷的预测因子 (1991美元).
- 包括286名随机选择患者的数据,检查随机化前的特征和治疗臂的分配.
主要成果:
- 平均初始医院费用为35,986美元,差异很大.
- 与HM相比,随机分配给EPS的患者的平均费用 (42,002美元与29,970美元) 较高,住院时间较长 (19.6天与13.9天),并接受了更多的药物试验 (3.0对2.1),与HM相比,随机分配给EPS的患者的平均费用更高 (42,002美元与29,970美元),住院时间更长 (19.6天与13.9天),并接受了更多的药物试验 (3.0对2.1).
- 呈现复苏的突然死亡和心力衰竭与增加的费用有关.
- 更高收费的独立预测因素包括未能找到有效药物,药物试验的数量,以及作为呈现心律失常的复苏突然死亡.
结论:
- 电生理学测试 (EPS) 导向治疗导致初始医院费用明显高于Holter监测 (HM) 导向治疗.
- 与EPS相关的成本增加归因于更多的药物试验和识别有效抗失常药物的可能性较低.
- 无法找到有效的药物,更多的药物试验,以及复苏的突发死亡史是初始住院费用增加的独立预测因素.
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