重症监护病房资源使用和费用的产生

Analysis of resource use and cost-generating factors in a surgical intensive care unit employing the therapeutic intervention scoring system

  • 摘要: 目的: 采用TISS评分评估重症监护病房(ICU)资源使用和费用产生。方法: 前瞻性研究。ICU住院日大于24h的患者。每日评估APACHEⅡ和TISS得分。患者按照TISS参数回顾性分为积极治疗组(AT)和非积极治疗组(NAT)。结果: 14 8个患者中131人(88.5%)分入AT组。AT组患者APACHEⅡ和TISS得分高于NAT组(P<0.01)。所有患者平均每天的费用为(6232.7± 4 365.7)元。AT组患者总费用(32800.5± 4 6723.5)元明显高于NAT组(685 2.1± 6132.4)元(P<0.01),每天的费用(6232.7± 4 365.7)元高于NAT组(274 5.8± 15 4 1.3)元(P<0.01),平均ICU住院日(5.4± 4.2) d也高于NAT组(2.2± 1.3) d (P<0.01)。结论: 接受AT治疗的患者病情重,总费用和每天的费用均明显高于NAT组,保证ICU收容质量可以节约资源。

     

    Abstract: Objective: To evaluate the resource use and costs in a surgical intensive care unit (SICU) with the Therapeutic Intervention Scoring System (TISS). Methods: Prospective observation were carried in consecutive patients with an ICU length of stay(ICU LOS) more than 24 hours. Patients were retrospectively classified as receiving active treatment(AT) or non-active treatment(NAT) according to the TISS variables, where AT mean therapeutic intervention that could not performed outside the ICU. Total expenditure for each patient was calculated. Results: of the 148 consecutive patients within this pariod,131 (88.5%), including non-survivors, were categorized as group in AT. TISS and LCU LOS were higher in patients receiving AT (P<0.01). Daily costs of the group AT were much higher than in the there of NAT patients (P<0.01). Conclusions: Total and daily costs of care were significantly higher in those receiving AT and in the ICU LOS. Therefore the cost-saving stratey should aim at reducing the ICU LOS, without compromising the quality of admittion.

     

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