密集护理,生存和治疗危急癌症患者的费用
D V Schapira1, J Studnicki, D D Bradham
1Section of Cancer Prevention, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612.
JAMA
|February 10, 1993
概括
进入重症监护室 (ICU) 的重症癌症患者的生存时间和在家的时间有限. 这项研究量化了这些患者每年获得的高生命成本.
科学领域:
- 在瘤学瘤学.
- 关键护理医学 关键护理医学
- 卫生经济学 卫生经济学
背景情况:
- 进入ICU的患有固体瘤和血液癌症的患者往往预后不好.
- 了解生存率和成本效益对于资源配置和患者护理决策至关重要.
研究的目的:
- 确定癌症ICU患者的存活率和影响存活率的因素.
- 为了评估在死亡之前在家里度过的时间 (有意义的生存).
- 计算每年获得的生命成本和每年在家获得的生命成本.
主要方法:
- 进行了生存率和成本效益分析.
- 从83名患有固体瘤的患者和64名患有血液癌症的患者收集了数据,这些患者在1988年至1990年期间被录入第三级癌症中心的ICU.
- 分析的因素包括年龄,性别,恶性瘤类型,ICU停留时间和机械通风需求.
主要成果:
- 机械通风是唯一影响血液癌症患者生存的重要因素.
- 超过75%的患者在死亡前在家里呆了不到三个月.
- 获得生命的一年成本为固体瘤的82,845美元和血液癌症的189,339美元; 在家的成本要高得多.
结论:
- 大多数进入ICU的癌症患者的存活时间有限,在家待的时间很短,这需要巨大的经济成本.
- 医生应该与患者和家人讨论预后和可能的生命支持撤回,以制定适当的护理策略.
- 这凸显了需要仔细考虑在危急癌症患者的侵略性治疗的必要性.
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