缺血性脑卒中医院护理的社会经济负担和成本-效果预测因素

M. Almasi, Paria Arfa-fatollahkhani, M. Bahadori, M. Moghaddasi, M. Fazel
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引用次数: 1

摘要

背景:脑卒中作为致残的最常见原因和死亡的第二大常见原因,对世界各地的卫生保健系统和社会产生了有害的社会经济影响。因此,我们的目的是调查伊朗患者在人力和医院成本方面的中风结果。方法:本研究纳入Rasoul-e-Akram医院诊断为缺血性脑卒中的患者。电话随访1个月至2年。死亡率和生存率分别采用Cox比例风险回归分析和Kaplan-Meier分析。采用t检验和Leven检验分析医院护理的经济预测因素和成本效益。结果:134例患者的住院死亡率和远期死亡率分别为7.46%和4.03%,1个月生存率为985.5%,2年生存率为96.3%。死亡率随年龄和初始脉搏率的增加而增加。保健系统的平均费用估计为61.905美元/天。在总费用中,护理服务和住宿费所占比例最大。药物治疗是第二昂贵的护理。成本效益分析确定会诊和实验室评估是最具成本效益的医院护理。结论:老年人有针对性的预防措施。同样,初始脉搏率高的患者应视为高危患者。本研究建议咨询和实验室作为卒中管理中具有成本效益的护理。
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Predictors of Socioeconomic Burden and Cost-Effectiveness of Hospital Cares for Ischemic Stroke
Background: Stroke as the most common cause of disability and the second common cause of death, has deleterious socio-economic impacts on the healthcare systems and societies worldwide. So we aimed to investigate stroke outcomes of Iranian patients in terms of human and hospital costs. Methods: In this study, patients admitted to Rasoul-e-Akram hospital, diagnosed with ischemic stroke were included. One month to 2 years telephone follow-up were applied. Cox proportional hazards regression analyses and Kaplan-Meier analysis were assigned for mortality and survival analyses, respectively. Economic predictors and cost-effectiveness of hospital cares were analyzed by T-test and Leven’s test. Results: Among 134 patients, in-hospital and long-term mortality rates were 7.46% and 4.03%, respectively and 985.5% of the patients survived for one month and 96.3% survived for 2 years. Mortality increased with age and initial pulse rate. The average of health-care system costs was estimated at 61.905$/day. The most proportion of total costs was attributed to the nursing services and bed-day costs. Medications were the second most costly cares. Cost-effectiveness analyses determined consultation and laboratory assessments as the significant cost-effective hospital cares. Conclusion: Specific preventive strategies are recommended for elderly people. As also, patients with high initial pulse rate should be considered as high-risk patients. This study suggests consultations and laboratories as the cost-effective cares in stroke management.
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