Costing of severe pneumonia in hospitalized infants and children aged 2-36 months, at a secondary and tertiary level hospital of a not-for-profit organization
Costing of severe pneumonia in hospitalized infants and children aged 2-36 months, at a secondary and tertiary level hospital of a not-for-profit organization
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DOI：
10.1111/j.1365-3156.2009.02374.x
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发表时间：
2009-10-01
影响因子：
3.3
通讯作者：
Bose, Anuradha
中科院分区：
文献类型：
--
作者：
Madsen, Helle Ostergaard;Hanehoj, Malin;Bose, Anuradha
为了确定卫生保健提供者的成本和家庭的治疗费用的严重肺炎的婴儿和幼儿承认二级和三级health care facility.METHODS的研究是在一个私人的，不以营利为目的的医学院医院，在韦洛雷，印度，在2008年中期。研究纳入了2-36个月的儿童，他们患有严重肺炎，没有潜在的慢性疾病。每天都要就与病人对费用的看法有关的问题与亲属进行面谈。这些费用包括直接医疗费用、直接非医疗费用（包括患病期间的旅行、住宿和特殊食品）以及家庭成员生产力损失的间接费用。从图表、护理记录、药房清单和医院账单中记录患者特定资源消耗和相关费用，并估计供应商对成本的看法。单位成本估计床天，治疗和调查inputs calculated.RESULTS总成本为一次发作的住院治疗的儿童肺炎在二级的卫生保健提供者为83.89美元（3524印度卢比）和146.59美元（6158印度卢比）在三级。在这两个层次上，最大的单一成本是住院本身，分别占总成本的74%和56%。诊断调查是一个很大的费用和支持治疗雾化和氧气治疗增加了成本。中等教育的平均家庭支出为41.35美元（1 737印度卢比），高等教育为134.62美元（5 655印度卢比），前者最大的单项支出是药品，后者是住院费。(one US$=INR 42.1（研究时）结论二级和三级治疗之间存在相当大的成本差异。以尽可能低的治疗水平接纳适当的病人可以减少提供者和病人承担的费用。
OBJECTIVES To determine health care provider cost and household cost of the treatment of severe pneumonia in infants and young children admitted to secondary and tertiary level health care facilities.METHODS The study was done in a private, not-for-profit medical college hospital, in Vellore, India, in mid-2008. Children aged 2-36 months admitted with severe pneumonia with no underlying chronic disease were included in the study. The relatives were interviewed daily on matters relating to patients' view point of the costs. These were direct medical costs, direct non-medical costs which comprised travel, accommodation and special food during the period of illness, and indirect costs of productivity loss for family members. Patient specific resource consumption and related charges were recorded from charts, nursing records, pharmacy lists and hospital bills, and the providers view point of the costs was estimated. Unit cost estimates for bed days, treatment and investigation inputs were calculated.RESULTS Total cost to health care provider for one episode of hospitalized childhood pneumonia treated at secondary level was US$ 83.89 (INR 3524) and US$ 146.59 (INR 6158) at tertiary level. At both levels the greatest single cost was the hospital stay itself, comprising 74% and 56% of the total cost, respectively. Diagnostic investigations were a large expense and supportive treatment with nebulization and oxygen therapy added to the costs. Mean household expenditure on secondary level was US$ 41.35 (INR 1737) and at tertiary level was US$ 134.62 (INR 5655), the largest single expense being medicines in the former and the hospitalization in the latter. (one US$=INR 42.1 at time of study)CONCLUSIONS A considerable cost difference exists between secondary and tertiary level treatment. Admission at lowest possible treatment level for appropriate patients could decrease the costs borne by the provider and the patient.