Severe Maternal Morbidity and Hospital Cost among Hospitalized Deliveries in the United States
Severe Maternal Morbidity and Hospital Cost among Hospitalized Deliveries in the United States
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DOI：
10.1055/s-0038-1649481
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发表时间：
2018-11-01
影响因子：
2
通讯作者：
Blackwell, Sean C.
中科院分区：
文献类型：
--
作者：
Chen, Han-Yang;Chauhan, Suneet P.;Blackwell, Sean C.
目的本研究的目的是估计当代国家严重孕产妇发病率（SMM）及其相关的住院费用在分娩hospitalization.Study设计我们进行了一项回顾性研究，确定所有分娩住院在美国之间的2011年和2012年。我们使用的数据来自医疗保健成本和利用项目的全国（全国范围内）住院患者样本。SMM分娩住院通过具有先前建立的25个诊断和程序代码列表中的至少一个来识别。估计总的和平均的住院费用。一个广义线性回归模型被用来检查SMM和医院costs.Results之间的关联7,438,946分娩住院确定，SMM率为154每10,000分娩住院。没有任何SMM，平均住院费用为4，300美元，有任何SMM，平均住院费用为11，000美元。调整后，与未合并SMM的患者相比，合并SMM的患者分娩住院费用是未合并SMM患者的2.1倍（95%可信区间：2.1-2.2），合并SMM的患者分娩住院费用是未合并SMM患者的10.3倍。结论合并SMM的患者住院费用是未合并SMM患者的2.1倍。我们的研究结果强调了确定干预措施和指导研究工作以减轻SMM及其经济负担的必要性。
Objective The objective of this study was to estimate the contemporary national rate of severe maternal morbidity (SMM) and its associated hospital cost during delivery hospitalization.Study Design We conducted a retrospective study identifying all delivery hospitalizations in the United States between 2011 and 2012. We used data from the National (Nationwide) Inpatient sample of the Healthcare Cost and Utilization Project. The delivery hospitalizations with SMM were identified by having at least one of the 25 previously established list of diagnosis and procedure codes. Aggregate and mean hospital costs were estimated. A generalized linear regression model was used to examine the association between SMM and hospital costs.Results Of 7,438,946 delivery hospitalizations identified, the rate of SMM was 154 per 10,000 delivery hospitalizations. Without any SMM, the mean hospital cost was $4,300 and with any SMM, the mean hospital cost was $11,000. After adjustment, comparing to those without any SMM, the mean cost of delivery hospitalizations with any SMM was 2.1 (95% confidence interval: 2.1-2.2) times higher, and this ratio increases from 1.7-fold in those with only one SMM to 10.3-fold in those with five or more concurrent SMM.Conclusion The hospital cost with any SMM was 2.1 times higher than those without any SMM. Our findings highlight the need to identify interventions and guide research efforts to mitigate the rate of SMM and its economic burden.