比較二種不同呼吸管路處置之醫療品質

Comparison of Weekly Standard Circuit Changes with Biweekly Disposable Heated Wire Circuit Changes versus Close System Humidifier on the Incidence of Nosocomial Pneumonia-A New Strategy to Reduce Cost

吳維琪(Vicky Wu) ； 盧崇正(Chong-Chen Lu)

《呼吸治療》 4卷1期 (2005/01) Pp. 25-34

https://doi.org/10.6269/JRT.2006.4.1.03

摘要

本文旨在研究呼吸器使用病患，藉抛棄型呼吸管路及自動密關性注水潮溫器之使用與傳統重覆消毒使用之管路作一比較。探討管路更換時間由現有之一周一次延長爲兩週一次，若無明顯之呼吸器相關肺炎發生率之差異，則可達到降低醫療成本支出。本研究主要對象爲台北市立聯合醫院中興院區，自民國92年4月16日至92年10月31日，凡入內外科加護病房，呼吸照護中心、及心臟加護病房之呼吸器使用病患，區分爲研究級與對照組，並作成本分析之比較。結果顯示，研究組個案93人、呼吸器相關肺炎感染率5.0/1,000呼吸器使用天數、換管總套數164組、耗用成本31,520.28元/台。對照組個案88人、呼吸器相關肺炎感染率6.3/1,000呼吸器使用天數、換管總套數278組、耗用40,483.03元/台，因此顯示抛型呼吸管路與自動密關性注水潮濕器之使用並延長爲兩週一次更換管路，在沒有增加呼吸器相關肺炎感染下，可達到降低醫療成本支出。

關鍵字

管路更換 ； 醫療成本分析 ； 及呼吸器相關肺炎

並列摘要

The study was conducted to approach a new strategy for the mechanically ventilated patient to reduce the cost with no effect of VAP rates. We compared the cost effectiveness we could make by means of biweekly disposable heated wire circuit change in combination with close system auto-feed humidifier instead of weekly standard reusable circuit change. Patients were subgrouped into study group and control group in MICU、SICU、RCC、and CCU at Chung-Shin municipal hospital during April 16, 2004 to October 31, 2004. As a result, the study group consisted 93 adults, VAP rate was 5.0 per 1,000 ventilator days, total 164 circuit changes, average cost was NT 31,520.20 dollars each. The control group consisted 88 adults, VAP rate was 6.3 per 1,000 ventilator days, total 278 circuit changes, average cost was NT 40,483.03 dollars each. In conclusion, the cost savings could be made by the new strategy.

並列關鍵字

Circuit Change ； Cost Effectiveness ； and Ventilator-Associated Pneumonia