An investigation of the hospital charges related to the treatment of endophthalmitis in the Endophthalmitis Vitrectomy Study.
An investigation of the hospital charges related to the treatment of endophthalmitis in the Endophthalmitis Vitrectomy Study.
复制标题
眼内炎玻璃体切除术研究中与眼内炎治疗相关的医院费用调查。
DOI：
10.1016/s0161-6420(97)30239-5
复制
发表时间：
1997
期刊：
影响因子：
13.7
通讯作者：
Doft,BH
中科院分区：
文献类型：
--
作者：
Wisniewski,SR;Hammer,ME;Grizzard,WS;Kelsey,SF;Everett,D;Packo,KH;Yarian,DL;Doft,BH
目的本研究的目的是使用眼内炎玻璃体切除术研究 (EVS) 的患者样本来评估与眼内炎治疗相关的医院费用。方法眼内炎玻璃体切除术研究是一项多中心、随机临床试验，采用 2×2 析因设计，比较立即玻璃体切除术与穿刺活检，并比较在术后眼内炎治疗中使用全身抗生素（静脉注射）与不使用静脉抗生素的情况。医院收费数据是从参与这项辅助研究的 4 个临床中心的 129 名患者中回顾性收集的。这占眼内炎玻璃体切除术研究总人群的 31%。使用方差分析来比较不同中心和治疗的医院费用。电荷有效性分析比较了不同治疗组的有效性。根据眼内炎的年发病率范围估算了美国每年节省的医院费用。结果静脉注射抗生素的使用显着增加了医院费用。接受玻璃体切除术的患者的住院费用明显高于接受活检的患者。对于仅有光感视力的患者来说，最有效的治疗方法是立即玻璃体切除术，而对于视力较好的患者来说，最有效的治疗方法是穿刺活检。与医院费用独立相关的治疗以外的因素包括女性性别、糖尿病史、红眼症状和仅光感基线视力。 结论假设眼内炎玻璃体切除术研究的结果被用作眼内炎治疗的指南，预计全国每年可减少医院费用760万至4000万。
PurposeThe purpose of the study is to assess the hospital charges associated with the treatment of endophthalmitis using a sample of patients from the Endophthalmitis Vitrectomy Study (EVS).MethodsThe Endophthalmitis Vitrectomy Study was a multicenter, randomized clinical trial with a two-by-two factorial design to compare immediate pars plana vitrectomy to tap—biopsy and to compare the use of systemic antibiotics (intravenous) to no intravenous antibiotics in the management of postoperative endophthalmitis. Hospital charge data were collected retrospectively from 129 patients from the 4 clinical centers participating in this ancillary study. This represents 31% of the total Endophthalmitis Vitrectomy Study population. An analysis of variance was used to compare hospital charges across center and treatment. A charge-effectiveness analysis compared measures the effectiveness across treatment groups. The annual savings of hospital charges in the United States was estimated for a range of annual incidence rates of endophthalmitis.ResultsThe use of intravenous antibiotics significantly increased hospital charges. Patients undergoing vitrectomy had significantly higher hospital charges than did patients undergoing tap—biopsy. The most charge-effective treatment for patients presenting with light perception only vision was immediate vitrectomy, whereas the most charge-effective treatment for patients presenting with better vision was tap—biopsy. Factors other than treatment independently associated with hospital charges were female sex, history of diabetes, symptom of red eye, and baseline vision of light perception only.ConclusionsAssuming the results of the Endophthalmitis Vitrectomy Study were used as a guide for the treatment of endophthalmitis, the estimated annual nationwide reduction of hospital charges would be between 7.6millionand 40.0 million.