Cost analysis of intensive glycemic control in critically ill adult patients
Cost analysis of intensive glycemic control in critically ill adult patients
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DOI：
10.1378/chest.129.3.644
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发表时间：
2006-03-01
期刊：
影响因子：
9.6
通讯作者：
Jones, RL
中科院分区：
文献类型：
--
作者：
Krinsley, JS;Jones, RL
研究目标：评估强化血糖管理方案对不同人群的危重成人患者护理费用的影响。设计：对1600名患者进行强化血糖管理前后的经济分析。地点：一所大学附属社区教学医院的14个病床的内外科混合成人ICU。患者：比较在强化血糖管理方案实施前连续在ICU住院的800名患者和在实施强化血糖管理方案后入住ICU的第一批800名患者。干预：使用ICU AS的综合数据库对成本数据进行分析以及其他医院数据仓库。测量和结果：ICU数据库用于量化医疗费用的主要组成部分。该分析包括与ICU和非ICU患者日、呼吸机日以及实验室、药房和放射学服务相关的成本。比较基线和治疗期，ICU患者天数、呼吸机天数、实验室、药房和放射学总成本以及ICU后住院时间都有所减少。在治疗期间，每年减少的费用净额为1,339,500美元，或每位患者1,580美元。结论：在ICU制定一项密集监测血糖水平并治疗即使是轻度高血糖的计划与实质性的成本节省有关。这一发现，加上先前显示的死亡率和发病率的改善，有力地支持了将这种干预作为ICU护理标准的采用。
Study objectives: To assess the effect of an intensive glycemia management protocol on the cost of care of a heterogeneous population of critically ill adult patients.Design: Economic analysis of a 1,600-patient "before-and-after" study of intensive glycemia management.Setting: Fourteen-bed mixed medical-surgical adult ICU of a university-affiliated community teaching hospital.Patients: Eight hundred consecutive admissions to the ICU prior to the institution of an intensive glucose management protocol were compared to the first 800 patients admitted to the ICU following institution of the protocol.Interventions: Cost data were analyzed using the comprehensive database of the ICU as well as other hospital data repositories.Measurements and results: The ICU database was used to quantify the major components of the cost of care. The analysis includes costs associated with ICU and non-ICU patient days, ventilator days, and laboratory, pharmacy, and radiology services. Comparing the baseline and treatment periods, there were decreases in patient days in the ICU; ventilator days; total laboratory, pharmacy and radiology costs; and post-ICU hospital length of stay. The net annualized decrease in costs during the treatment period was $1,339,500, or $1,580 per patient.Conclusions: The institution of a program to intensively monitor glucose levels and treat even modest hyperglycemia in the ICU was associated with substantial cost savings. This finding, in conjunction with the previously demonstrated improvement in mortality and morbidity, strongly supports the adoption of this intervention as a standard of care in the ICU.