严重急性呼吸综合征(SARS)定点医院防治费用评价及对医院经济的影响

Treatment of severe acute respiratory syndrome (SARS) in designated hospital: expenditure analysis and the impact of SARS on hospital economics

背景 广元市 4 10医院于 2 0 0 3年 2月、4月分两批共收治 6例SARS确诊病人 ,至今已治愈 5例 ,4月 2 5日成为四川SARS定点医院。目的 :评价SARS定点医院防治费用及对医院收入和运作的影响。方法 :从定点医院的观点 ,以治愈率为临床效果指标 ,回顾性评价SARS确诊和疑似病人的治疗费用 ,定点医院总体防治的费用 ,SARS定点医院对总体、医疗和药品收入 ,门诊和住院就诊病人的影响。敏感性分析评价院内感染和治愈率的变化对费用的影响。结果 :5例确诊 ,6例疑似病人均治愈。人均治疗费用分别为 786 6和 4 2 73元 ,医疗费用分别为 14 983.86和 5 4 94 .92元。除药物支持治疗外 ,其余各项费用在确诊和疑似病人间无统计学意义。SARS定点医院总体防治费用为 174 .4 5万元。指定为定点医院前后 ,医院收入和门诊、住院人数分别下降 33.4 5 % ,4 3.6 2 %和 4 7.33%。结论 :SARS确诊病人费用为 14 983.86元。定点医院将明显影响医院收入和运作。

Background: 410 Hospital, a hospital in an undeveloped city, identified the first three SARS cases in February, and three more cases in April in Sichuan province. After April 25, it was designated to treat the SARS cases. Objectives: This study aims to assess the expenditure for prevention and control of SARS in designated hospital and the impact of SARS on hospital management. Methods With the perspective of SARS designated hospital, a retrospective study was designed. The measures for benefit was healing rate. Medical expenditures of SARS treatment was evaluated,total expenditare were included for assessment in SARS control and management in designated hospital. Sensitivity analysis was applied to explore the range of expenditures when hospital infection rate and healing rate varied.Results All five SARS cases and six suspected cases were cured. The treatment expenditure for SARS confirmed and suspected cases were 7866 and 4273 RMB, and their medical expenditures were 14983.86 and 5494.92 RMB. Except the expenditure of supporting drugs, no statistical significance was identified in expenditures between confirmed and suspected cases. The total expenditure for designated hospital in control and management of SARS was 1.7445 million RMB. After designation, the total income of the hospital decreased 33.45 percent compared that before designated. The hospital visits in out-patient and in-patient departments drop 43.62 and 47.33 percent. Conclusions The expenditure of treatment of confirmed and suspected SARS cases were 14983.86 and 5490.92 RMB. After designation, the hospital would be great influenced in its management and income.