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91.
目的分析2010-2019年住院治疗的肝脓肿患者基本情况、住院费用及其结构变化和影响因素,评估肝脓肿直接经济负担,探寻有效减轻肝脓肿疾病经济负担的方法。方法回顾性收集中南大学湘雅医院2010年1月-2019年12月收治的495例肝脓肿住院患者资料,分析逐年住院费用变化、各项住院费用变化、各临床特征与住院费用的相关关系,多元逐步回归分析住院费用影响因素。结果 495例病例中,平均住院日为15.93 d,人均住院费用34 548.02元,所有项目费用中西药类占比最高;既往有肝胆手术史、肿瘤病史、治疗过程中合并胸腔积液、肺部感染、采用手术治疗患者住院费用显著升高(P<0.05);多因素回归分析提示住院天数越长、治疗手段越复杂、合并肿瘤史、出现胸腔积液患者住院费用更高。结论 2010-2019年住院治疗肝脓肿人均费用34 548.02元,其中西药费用占比最高,诊断类费用逐年增长,不同特征患者住院费用有差异。住院日、治疗手段、肿瘤史、合并胸腔积液均会对住院费用产生影响。 相似文献
92.
All district health authorities are obliged to use resources most efficiently. One approach to increasing efficiency is to identify measures which allow service levels, in terms of patients treated and standards of care, to be maintained at a lower cost. This could be achieved by maintaining service levels with fewer hospital beds. Reducing lengths of stay by removing organizational delays and expansions of day-case care, are policies which can increase patient caseload per bed. This paper puts forward an approach for estimating the resources released by such policies and assesses the savings achieved by realizing efficiency gains identified in a previous study by Beech et al. (1987). That study identified significant potential for maintaining services with fewer beds, with the expansion of day-case care being a key mechanism. However this paper concludes that when services are maintained with fewer beds, the vast majority of hospital costs remain fixed. It also reaches the alarming conclusion that as a vehicle for reducing costs, day-case care is much less effective than previous studies have implied. However, increasing hospital throughput per bed does release capacity to treat more patients. The proposed reforms of the NHS (Secretaries of State, 1989) envisage an internal market for health care, allowing hospitals to enter into contracts with purchasers of health care. The approach to costing described in this paper is applicable to assessing the increased costs associated with such developments. These extra costs can then be compared with expected income. 相似文献
93.
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95.
D. A. Stewart D. Guo J. A. Sutherland B. A. Ruether A. R. Jones M.-C. Poon C. deMetz J. Klassen A. Chaudhry C. B. Brown J. A. Russell 《Annals of oncology》1997,8(12):1277-1279
Background: Few data are available on the cost, safety, and long-termefficacy of single agent high-dose melphalan (HDM) followed by autologousbone marrow (ABMT) or blood stem cell (ABSCT) transplantation in the salvagetherapy of Hodgkins disease (HD).Patients and methods: From February 1981 to September 1996, 23 patientswith relapsed (n = 15) or refractory (n = 8) HD received salvage therapywith HDM 140–200 mg/m2 followed by non-cryopreservedABMT (n = 18) or cryopreserved ABSCT (n = 5). The cost of HDM/ABSCT in 1996,from initial consultation until transfer back to referring physician, wasdetermined and compared to the estimated costs of two multi-agent regimenscommonly used for HD.Results: HDM was well tolerated with no early transplant-relatedmortality. The five-year overall and progression-free survival rates were52% and 50%, respectively. The average total cost in Canadianfunds of HDM/ABSCT in 1996 was $34,400/patient. This cost wasestimated to be $4,700–6,800 cheaper per patient than themulti-agent high-dose regimens.Conclusion: These data suggest that HDM is safe, feasible, active, andreasonably inexpensive salvage therapy for patients with relapsed/refractoryHD. 相似文献
96.
Omoto M Imai T Seki K Nomura R Otahara Y 《Environmental health and preventive medicine》1997,2(3):105-116
Based on the fact that chemical products such as binding agents are produced by mixing three kinds of phosphates with different
ratios, we mixed metaphosphate, polyphosphate and pyrophosphate. Each was made to Na-phosphate, K-phosphate, and Ca-phosphate
and each was mixed with commercial feeds so that the content of P would be approximately 0.1, 0.15, 0.3, 0.4, 0.6 and 1.0%.
The prepared pellets were given to ICR, CF # 1 and AKR strains of mice at 29 days of age for 680 days and observations were
made through this experimental period at different stages. The observations were also carried out on the mice administered
with the experimental feeds for 1.5 months from 9 to 10.5 months of age. The observations were compared with those of the
control group at all times. As a result, plasma 1 α, 25 (OH)2 D3 and P levels were always significantly higher in the phosphate administered groups relative to the control. Urine P and Fe
increased while urine Ca decreased in the phosphate-treated groups.
The effect of phosphates on the bones was studied taking soft X-ray pictures of hind legs and applying microdensitometry to
them. Through these observations we recognized thinning of the cortex of bones, reduction of marrow trabecules and development
of osteophyte. Histological observations disclosed that changes in knee joint tissues were apparent; that is, a decrease in
or an irregular loss of the number of cells in superficial, intermediate, and radial strata of the joint cartilage, proliferation
of subchondral bone, and the development of osteophytes were noted. As for muscles, diameters of musclar fibers became smaller;
in particular, type II fibers showed greater shrinkage. Regarding kidneys, swelling and atrophy of glomerular capillaries,
proliferation of mesangial cells, nephroselerosis, swelling, thinning, and loss of tubular epithelium, interstitial tissue
inflammation, development of cylindruria, and deposition of calcium were observed. All these changes seem to be a particularly
advanced aspect of the changes which are more pronounced with increasing dose and age.
These changes were found even in the group administered with the feed containing 0.1% phosphorus, and, these changes were
dependent on the concentration level of P. It was observed that administration to older subjects for a short term (1.5 months)
produced effects stronger than those to younger subjects administered for a long term (10.5 months).
The effects of condensed Ca-phosphate on bones were similar to those of condensed Na- and K-phosphates, and, hence, it was
supposed that these effects were caused by phosphate radicals.
An erratum to this article is available at . 相似文献
97.
Graves HA 《Obesity surgery》1994,4(3):232-237
To help answer the call to cut costs of surgical care, hospitals and physicians have joined to compare methods of care for
the more common Diagnosis Related Group (DRG) diagnoses to form a Benchmark. Since many bariatric surgeons are the only ones
performing this surgery in their primary hospitals, they do not have two or more surgical routines for comparison. This presentation
compares data for the preoperative work-up, operating-room, and methods of postoperative care used by 29 members of the American
Society for Bariatric Surgery (ASBS). There was representation of both academic and private surgeons and hospitals. To target
areas for possible savings, the hospital bills of 16 patients without complication were compared. The synthesis of this information
revealed significant differences in the extent and cost of preoperative work-up, antibiotic coverage, other postoperative
care, and length of stay. These differences are examined under the assumption that patient outcome was the same. 相似文献
98.
M. C. Montero M. L. Valdivia E. Carvajal A. Montaño C. Buenestado A. Lluch M. Atienza 《Pharmacy World & Science》1994,16(4):187-192
This article describes the economic and social impact of nutropenia induced by myelotoxic chemotherapy in patients with cancer during the period 1 January–31 December 1991. Neutropenia is a life-threatening complication of chemotherapy in patients with cancer. The episodes of (ever and infections originating from neutropenia require hospitalization of the patient until the granulocyte levels are restored. The calculation of the economic cost was based on the following parameters: length of stay in hospital, analytical tests performed on the patient, type and cost of drug therapy administered, blood transfusions performed, health assistance received, cost of isolation and absence from work. The overall economic cost of neutropenia in patients with cancer reached 329,775 pesetas ($2,893). Cost of the health-care staff was the largest budget item in relation to the total health resources estimated. 相似文献
99.
100.
目的 探讨上肢机器人虚拟情景训练联合头针对脑卒中后认知功能障碍的影响。 方法 选取脑卒中后认知功能障碍(PSCI)患者90例,按照随机数字表法分为对照组、头针组、综合组,每组30例。对照组给予常规认知和康复训练,头针组给予常规认知和康复训练联合头针治疗,综合组给予常规认知和康复训练、头针治疗和上肢机器人虚拟情景训练。治疗前和治疗4周后(治疗后),采用简易精神量表(MMSE)和蒙特利尔认知评估量表(MoCA)评估3组患者认知功能,同时采用改良的Barthel指数(MBI)评估3组患者日常生活活动能力。 结果 治疗后,3组患者的MMSE评分、MoCA评分和MBI评分较组内治疗前均明显改善(P<0.05)。头针组治疗后,仅MMSE评分和MBI评分显著优于对照组治疗后(P<0.05)。综合组治疗后的MMSE评分为(22.03±0.96)分,MoCA评分为(15.07±1.48)分,MBI评分为(73.10±8.45)分,均显著优于头针组和对照组治疗后(P<0.05)。 结论 上肢机器人虚拟情景训练联合头针可显著改善PSCI患者的认知功能,并提高其日常生活活动能力。 相似文献