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PLos One:心脏手术后的医疗资源利用和心肺并发症的费用

2020-01-17 xiangting MedSci原创

这项研究表明,心脏手术后HF和RF并发症的发生率很高,并且手术后1年内与并发症相关的医疗资源利用导致了大量的增量成本。

这项研究探讨了心脏手术后1年的术后心力衰竭(HF)和呼吸衰竭(RF)并发症以及相关的医疗资源利用。

该研究从Cerner健康实例®数据库确定接受单独冠脉搭桥术(CABG)和/或瓣膜手术的成年患者。纳入术后发生HFRF并发症的患者。使用住院频率、伴或不伴住院的急诊室(ED)就诊以及门诊就诊来量化医疗资源利用。然后,研究人员从确定的医疗资源利用中确定直接的医院费用。还分析了HFRF随时间的变化趋势,并评估了手术类型与HF并发症的关联。

HF合并症的10,298例患者中,1,714例(16.6%)出现了持续性HF;在10,385RF患者中,有175例(1.7%)出现了持续性RF。指数出院后1年内有持续性并发症患者的医疗资源利用包括以下几种就诊类型的平均数:住院(1.49 HF1.55 RF),门诊(2.020.51),没有住院的ED0.33 0.13),急诊室+住院(0.080.06)。每位患者每年与持续性HFRF并发症相关的费用分别为20,857美元和30,745美元。心脏手术的类型与HF发生率之间存在显著相关性,单独瓣膜手术的风险(调整后OR2.60 95CI2.35-2.88)和CABG+瓣膜手术的风险(调整后OR2.38 95CI2.17- 2.61)超过了单独CABG手术的风险。

这项研究表明,心脏手术后HFRF并发症的发生率很高,并且手术后1年内与并发症相关的医疗资源利用导致了大量的增量成本。考虑到付款人和医疗提供者集中降低医疗成本的需要,这项研究填补了量化心脏手术后并发症中期经济影响的重要空白。

原始出处:

Mitali Stevens. Healthcare utilization and costs of cardiopulmonary complications following cardiac surgery in the United States. PLos One. December 2019.

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    2020-02-05 aids222
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    2020-09-18 丁鹏鹏
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