加护病房患者的变动成本：多中心前瞻性研究外文翻译.docVIP

外文翻译 原文 Variable cost of ICU patients:a multicenter prospective study Material Source:Intensive Care Med(2006) 32:545-552 Author:Carlotta Rossi Abstract Objective To analyze thecosts of treating critically ill patients. Design and setting: Multicenter, observational, prospective, cohort,bottom-up study on variable costsin 51 ICUs. Patients and participants: A total of 1,034 patients aged over 14 years who either spent less than 48 h in the ICU or had multiple trauma, major abdominal surgery, ischemic stroke, chronic obstructive pulmonary disease, cardiac failure, isolated head injury, acute lung injury/adult respiratory distress syndrome (ALI/ARDS), nontraumatic Conclusions: Cost of treatment in an ICU varies widely for different types of patients. Strategies are needed to contain the major determinants of high costs and low cost-efficiency. Costing strategy The monetary cost of each item considered was recorded. Drug costs were one-half retail prices (which is what hospitals are charged in Italy). The 2000 national price list provided by theMinistry of Health was used to cost laboratory and imaging tests. For all the other 235 items ICUs were asked to provide the prices actually paid in 2000. Since only 32 ICUs (63%) were able to provide these, we calculated the mean price for each item from the available data and applied this to all ICUs. In some cases (21.9%) such as pulmonary artery catheters we found outliers (ICUs paying disproportionately high prices compared to others). When this happened and the data were not corrected after the proper query, we computed trimmed means. We then subdivided the cost structure for each single patient into seven headings: drugs, where the cost was related to the quantity consumed; nutrition, excluding nutritional devices; infusions, including blood and blood products; consumables, including nutritional devices, catheters, and all kinds of kits (e.g., for ventilation, dialys