醫院對急性白血病人保護隔離之成本效益研究

A Cost Effectiveness Study of Protection for Leukemia Patients

星雙鈺(Nelson Hsing) ； 金春華(Chuin-Hwa Chin) ； 許惠媚(Hui-Mei Shu) ； 趙秀雄(Shiu-Hsiung Chao)

《中華公共衛生雜誌》 15卷1期 (1996/02) Pp. 80-90

https://doi.org/10.6288/CJPH1996-15-01-06

摘要

Infection is the primary cause of death in acute leukemia patients. For years, hospitals have been practicing protective precautions to prevent patients from being infected. However, there is no consensus as to what protective precaution measures should be provided. One school of thought is that more frequent rounds should be made to patients, and preventive treatment given in time. This study was designed to explore the cost-effectiveness of protective precaution measures for acute leukemia patients. We have defined effectiveness as overall infection rate, the time interval between chemotherapy and the onset of first infection and the number of times infection occured. The result showed complete protective precaution measures cost NT $23,000 more than simple precaution measures for each episode (p＜0.001), while the comparisons of effectiveness did not show statistical significance. Through survival analysis, we found that complete protective precaution may delay the onset of infection for 2 to 3 days longer than simple precaution. Nevertheless, there was no difference in the total number of infections between the two groups, indicating rigid protective precaution may not be as effective as we thought in terms of reducing the chance of patients being infected.
Although this study does not show what effect different chemotherapy dosages have on the chance of infection, we feel that future research may demonstrate a relationship. Whether delay of infection has an impact on patient mortality remains an interesting question and is suggested for further study.

關鍵字

存活分析 ； 保護隔離 ； 成本效益 ； 醫務管理

並列摘要

Infection is the primary cause of death in acute leukemia patients. For years, hospitals have been practicing protective precautions to prevent patients from being infected. However, there is no consensus as to what protective precaution measures should be provided. One school of thought is that more frequent rounds should be made to patients, and preventive treatment given in time. This study was designed to explore the cost-effectiveness of protective precaution measures for acute leukemia patients. We have defined effectiveness as overall infection rate, the time interval between chemotherapy and the onset of first infection and the number of times infection occured. The result showed complete protective precaution measures cost NT $23,000 more than simple precaution measures for each episode (p＜0.001), while the comparisons of effectiveness did not show statistical significance. Through survival analysis, we found that complete protective precaution may delay the onset of infection for 2 to 3 days longer than simple precaution. Nevertheless, there was no difference in the total number of infections between the two groups, indicating rigid protective precaution may not be as effective as we thought in terms of reducing the chance of patients being infected.
Although this study does not show what effect different chemotherapy dosages have on the chance of infection, we feel that future research may demonstrate a relationship. Whether delay of infection has an impact on patient mortality remains an interesting question and is suggested for further study.

並列關鍵字

survival analysis ； protective precaution ； cost effectiveness ； hospital administration