Components of Hospital Charges for Acute Care of Nursing Home Patients in Chicago, U. S. A.

美國芝加哥區養老院病人住院診治費用之分析

許清曉(Clement C. S. Hsu) ； 許玉麗(Yui-Li Hsu)

《中華民國公共衛生學會雜誌》 10卷2期 (1990/06) Pp. 104-113

https://doi.org/10.6288/JNPHARC1990-10-02-04

摘要

吾等於1984年至1985年間在芝加哥一社區教學醫院對326名養老院病人之急診住院做一前瞻性的研究，調查其診斷、治療結果以及各項住院費用。入院天數之中間值為9.5天，住院費用則為7,285美金，而每天費用為813美金。住院費用中房間費佔35%，而8%則花在靜脈注射用抗生素。
住院時有感染之病人(n=194)比無感染者(n=132)住院天數加長兩天，而每天費用則高出22%。在有感染病人當中，發生合併症者之住院費用比無合併症者高出26%；死亡病患之費用比生存病患者高出35%。”不可復甦”之醫囑並沒有減低住院費。欲防止醫院醫療費用之不斷高漲，醫界需要對生命品質極低而成本效益惡劣之病人是否繼續診療之問題訂立適當的指引。

並列摘要

Hospital charges, clinical features and outcome in 326 nursing home patients admitted for acute care were prospectively studied for 1984 and 1985 at a community teaching hospital in Chicago. The median length of stay was 9.5 days, and the median total hospital charge and charge per day were $7,285 and $813, respectively. The basic room charge accounted for 35% of the total, while antimicrobial therapy accounted for 8% of the charges.
Patients with infections (n=194) stayed a median length of 2 days longer and incurred daily charges 22% higher than those for patients in the noninfection group (n=132). For patients with infection, the occurrence of major complications (17.5%) and death (16.5%) were associated with higher per day charges of 26% and 35%, respectively ”Do not resuscitate” orders were not significantly associated with lower hospitalization costs. To control the high cost of hospital care, guidelines are needed for the management of patients in situations where the quality of life is very low and the cost-benefit ratio is minimum.

並列關鍵字

Cost and Cost Analysis ； Nursing Homes ； Infection ； Complications ； Death