A national study for regional variation of inpatient ECT utilization from 4,411 hospitals across the United States.
A national study for regional variation of inpatient ECT utilization from 4,411 hospitals across the United States.
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一项针对美国 4,411 家医院住院患者 ECT 使用情况区域差异的全国性研究。
DOI：
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
N. Youssef
中科院分区：
文献类型：
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作者：
R. Patel;Venkatesh Sreeram;T. Thakur;R. Bachu;N. Youssef
背景
我们进行了一项研究，以检查美国各地住院患者电休克治疗（ECT）使用的区域差异，及其对住院时间和费用的影响。
方法
分析全国住院患者样本数据库，以比较患者和医院特征，以及美国不同地区ECT管理的地区差异。
结果
该研究包括来自4，411家医院的41，055名住院患者。电休克疗法的使用在中西部明显更高。在美国，接受ECT治疗的女性比例（65.2%）高于男性。与医疗保险（52.2%）或私人保险（32%）的患者相比，医疗补助受益人不太可能接受ECT。电休克治疗主要用于心境障碍（84.3%）。有显着减少住院费用（25,298美元至38,244美元）和平均住院时间（16天）时，开始在入院的前5天内与后来在住院期间。
结论
ECT的使用有很大的差异，取决于地区，医院类型和保险公司的类型。ECT服务的使用率在美国各地都有所下降。适当利用这种有效的治疗方法可以极大地帮助那些对标准疗法没有反应的患者，降低整体医疗保健成本和住院时间，最重要的是减轻痛苦。
BACKGROUND
We conducted a study to examine regional variation in the utilization of inpatient electroconvulsive therapy (ECT) across the United States, and its impact on length of hospital stay and cost.
METHODS
Analysis of the Nationwide Inpatient Sample databases to compare patient and hospital characteristics, and regional variation of ECT administration across different regions of the United States.
RESULTS
The study included 41,055 inpatients who had ECT from 4,411 hospitals. Electroconvulsive therapy use is significantly higher in the Midwest. A higher proportion of females (65.2%) than males received ECT across the United States. Medicaid beneficiaries were less likely to undergo ECT compared with patients with Medicare (52.2%) or private insurance (32%). Electroconvulsive therapy was used mainly for mood disorders (84.3%). There were marked reductions of inpatient costs ($25,298 to $38,244) and average hospital stay (16 days) when ECT was initiated within the first 5 days of admission compared with later during the hospitalization.
CONCLUSIONS
There is a wide variability of utilization of ECT, depending on the region, type of hospital, and type of insurance carrier. The utilization of ECT services is reduced across the United States. Appropriate utilization of this effective treatment can greatly help patients who are not responding to standard therapeutics, reduce overall health care cost and length of stay, and, most importantly, alleviate suffering.