A comparison of the costs and survival of hospital-admitted stroke patients across Europe
A comparison of the costs and survival of hospital-admitted stroke patients across Europe
复制标题
DOI：
10.1161/01.str.32.7.1684
复制
发表时间：
2001-07-01
期刊：
影响因子：
8.3
通讯作者：
Wolfe, CDA
中科院分区：
文献类型：
--
作者：
Grieve, R;Hutton, J;Wolfe, CDA
背景和目的-政策制定者需要关于不同中风护理组织方式的成本和结果的证据，这项研究比较了提供中风护理的不同方式的成本和存活率。方法纳入来自13个欧洲中心的住院中风患者，测量每个患者的人口统计学、病例组合和资源使用变量。收集了单位预测，并使用购买力平价(PPP)指数将其转换为美元。使用COX和线性回归分析比较不同中心之间的存活率和费用。结果：共有1847名患者纳入研究。经过病例组合调整后，平均预测费用从里加(拉脱维亚)的466美元[95%可信区间181至751]到哥本哈根(丹麦)的8512美元[7696至9328]不等，这反映了单位成本和资源使用的差异。平均住院时间从梅诺卡(西班牙)的8.3天到图尔库B(芬兰)的36.8天不等。在芬兰的3个中心中，至少80%的患者被送往提供有组织的中风护理的病房，而阿尔马达(葡萄牙)、梅诺卡或里加的中心没有提供这种护理。图尔库A和图尔库B的患者比里加、华沙(波兰)或梅诺卡的患者死亡的可能性更小。与里加相比，调整后的风险比分别为：图尔库A 0.18[0.10~0.32]、图尔库B 0.18[0.10~0.32]、华沙0.68[0.48~0.96]、梅诺卡0.56[0.33~0.96]。需要进一步的研究来评估哪些组织中风护理的方法是最具成本效益的。
Background and Purpose-Policy makers require evidence on the costs and outcomes of different ways of organizing stroke care, This study compared the costs and survival of different ways of providing stroke care.Methods Hospitalized stroke patients from 13 European centers were included, with demographic, case-mix, and resource use variables measured for each patient. Unit casts were collected and converted into US dollars using the purchasing power parity (PPP) index. Cox and linear regression analyses were used to compare survival and costs between the centers adjusting for case mix.Results - A total of 1847 patients were included in the study. After case-mix adjustment, the mean predicted costs ranged from $466 [95% CI 181 to 751] in Riga (Latvia) to $8512 [7696 to 9328] in Copenhagen (Denmark), which reflected differences in unit costs, and resource use. The mean length of hospitalization ranged from 8.3 days in Menorca (Spain) to 36.8 days in Turku B (Finland). In the 3 Finnish centers at least 80% of patients were admitted to: wards providing organized stroke care, which was not provided at the centers in Almada (Portugal), Menorca, or Riga. Patients m Turku A and Turku B were less likely to die:than those in Riga, Warsaw (Poland), or Menorca. The adjusted hazard ratios were 0.18 [0.10 to 0.32] for Turku A, 0.18 [0.10 to 0.32] for Turku B, 0.68 [0.48 to 0.96] for Warsaw, and 0.56;[0.33 to 0.96] for Menorca, all compared with Riga.Conclusions The cost of stroke care varies across Europe because of differences in unit costs, and resource use. Further research is needed to assess which ways of organizing stroke care are the most cost-effective.