误诊病例的经济损失评估

目的了解临床误诊所导致的直接经济损失。方法采用1∶1配对的病例对照研究方法,调查某院2005年间所有误诊的病例,并寻找与之配对的无误诊病例,得到符合配对条件的病例共34对,计算两组病例的平均费用和平均住院日。结果误诊组的平均费用为6310元,而对照组为5496元(p=0.005);误诊组的平均住院日为9.6d,而对照组为8.3d(p=0.012)。费用的增加以西药费为最高,占总增加费用的34.1%,其次是治疗费、化验费和检查费,分别占22.5%、15.3%和10.4%。结论误诊增加了医疗费用支出,延长了住院日。降低误诊率可以减少浪费,提高经济效益和社会效益。

A MATCHED CASE CONTROL ANALYSIS ON DIRECT ECONOMIC COSTS OF MISDIAGNOSIS

Objective To evaluate the direct economic costs of Misdiagnosis. Method A matched case control study was conducted among the hospitalized patients which were misdiagnosed in a certain hospital in 2005, the matched cases without misdiagnosis were sought, 34 pairs of patients accorded with the pair qualifications, the average length of hospital stay and average medical costs of two groups were calculated. Result The average medical cost for patients in the case group was 6 319 RMB Yuan, while the average medical cost in the control group was 5 496 RMB Yuan (p=0.005). The average length of hospital stay was 9.6 days in the case group and 8.3 days in the control group (p=0.012). The largest part of extra costs was found in drug expense, taking up 34.1%, while other extra costs such as therapies, laboratory examinations, and inspections accounted for 22.5%, 15.3% and 10.4% respectively. Conclusion Misdiagnosis had significantly added to the economic burden of medical treat ment, and prolonged the hospitalization of the patients. To lower the misdiagnosis rate may reduce the waste, and enhance the economic profits and social profits.