Estimating the health care costs associated with recurrent cellulitis managed in the outpatient setting
Estimating the health care costs associated with recurrent cellulitis managed in the outpatient setting
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DOI：
10.1016/j.jaad.2017.09.010
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发表时间：
2018-04-01
影响因子：
13.8
通讯作者：
Kroshinsky, Daniela
中科院分区：
文献类型：
--
作者：
St John, Jessica;Strazzula, Lauren;Kroshinsky, Daniela
背景资料：复发性蜂窝组织炎是诊断在22%至49%的所有蜂窝组织炎的情况下，但很少有人知道与这些cases.Objective相关的费用：描述患者在门诊复发性蜂窝组织炎，并估计相关费用。对2007年1月1日以来在我院门诊就诊的成人患者进行了回顾性病历审查，至2011年12月31日，复发性蜂窝织炎。由医疗保险和医疗补助服务中心提供的数据used.Results：共157例患者被确定，56%为男性，平均年龄为62.7岁。每例患者蜂窝织炎的平均发作次数为3次。所有诊断为复发性蜂窝织炎的患者均接受抗生素治疗，其中93%接受口服抗生素治疗，17.6%接受静脉注射抗生素治疗。共进行了1081次实验室检查和175次放射学成像检查。每次蜂窝织炎发作的最低平均费用为586.91美元;每次就诊的平均费用为292.50美元。局限性：回顾性研究;使用单个大型学术机构;使用的费用估计可能无法充分反映封闭系统研究中心或地理区域之间的费用差异。有没有考虑到非经济或机会成本与住院治疗，如失去工作或儿童保育和任何长期的发病率，除others.Conclusions：复发性蜂窝织炎在门诊设置的成本约为586.91美元每集。虽然没有诊断或治疗蜂窝织炎的标准，我们的分析表明，需要更多的循证管理，以实现更好的结果，并减少显着的医疗保健费用。（J Am Acad Dermatol 2018;78：749-53.）
Background: Recurrent cellulitis is diagnosed in 22% to 49% of all cellulitis cases, but little is known about the costs associated with these cases.Objective: To characterize patients with recurrent cellulitis in the outpatient setting and estimate the associated costs.Methods: A retrospective chart review was conducted for adult patients who presented to the outpatient facilities at our institution from January 1, 2007, to December 31, 2011, with recurrent cellulitis. Data provided by the Centers for Medicare and Medicaid Services were used.Results: A total of 157 patients were identified; 56% were male, with a mean age of 62.7 years. The mean number of episodes of cellulitis per patient was 3. Antibiotics were prescribed for all patients with a diagnosis of recurrent cellulitis, with 93% treated with oral antibiotics and 17.6% treated with intravenous antibiotics. A total of 1081 laboratory and 175 radiologic imaging tests were ordered. The minimum average cost per cellulitis episode was $586.91; the average cost per visit was $292.50.Limitations: Retrospective study; use of a single, large academic institution; and utilization of cost estimates that may not adequately reflect the variation of costs across closed-system sites or geographic regions. There was no accounting for the nonfinancial or opportunity costs associated with hospitalization, such as lost days of employment or child care and any long-term morbidities, among others.Conclusions: Recurrent cellulitis in the outpatient setting costs about $586.91 per episode. Although there is no criterion standard for diagnosis or treatment of cellulitis, our analysis demonstrates the need for more evidence-based management to achieve better outcomes and reduce the significant health care costs. (J Am Acad Dermatol 2018;78:749-53.)