肿瘤患者化疗中2种深静脉置管应用效果及专项护理成本比较

目的 对PICC及颈内静脉置管的实际护理成本与现行收费标准进行对比,证实实际护理成本与现行收费之间的偏差,在此基础上对比两者在肿瘤患者化疗中的利弊.方法 用项目成本阶梯分摊法,对接受PICC及颈内静脉置管患者实际投入的人力、财力、物力进行测量、归集、统计,核算出的实际护理成本并与其现行的收费标准进行对比；分析其成本及临床应用价值.结果 PICC实际成本(2259.99±30.99)元与现行收费标准1532.79元差价为-727.20元,颈内静脉置管实际成本(393.86±33.93)元与现行收费标准292.13元差价为-101.73元；PICC后并发症发生率为12％,颈内静脉置管为17％.HCC及颈内静脉置管实际专项护理成本大于现行收费价格,PICC的单次护理成本是颈内静脉置管的5.74倍,以一年4～6个化疗疗程计算,PICC护理成本与颈内静脉置管总成本(1年内)比较无显著差异,并发症发生率比较无显著差异.结论 临床应用PICC的优点多于颈内静脉置管,应优选PICC,次选颈内静脉置管.

Comparing of the cost of special nursing and application effect between two ways of deep veins catheter in patients with chemotherapy

Objective To confirm the deviation between the present charge and real cost of nursing by comparing them between PICC and jugular veins catheter,and the advantages and disadvantages were weighed between them in tumor patients undergoing chemotherapy.Methods The cost of manpower,financial resources or materials for 106 patients with PICC,68 patients with jugular veins catheter were measured,accounted and statistically analyzed with the ladder sharing method for project cost.Comparing the cost between calculation cost and current charging standard,and the cost and clinical application was studied.Results The real cost of PICC was (2259.99±30.99)Yuan and current charging standard was 1532.79 Yuan,the deviation was -727.20 Yuan,and the real cost of jugular veins catheter was (393.86±33.93) Yuan,and current charging standard was 292.13 Yuan,the deviation was -101.73 Yuan.The complication rate was 12％ in PICC,17％ in jugular veins catheter.The real cost of nursing on PICC and jugular veins catheter was higher than current charging standard,and the real cost of single nursing on PICC was 5.74 times higher than jugular veins catheter.The cost remains unchanged with 4～6 course of chemotherapy treatments in a year.Conclusions The advantages of PICC are more than jugular veins catheter,so the preferred choice is PICC,and jugular veins catheter comes secondary.