2019冠状病毒病疫苗对第四、第五和第六波大流行期间重症监护病房住院费用的影响

IF 1.1 Q3 NURSING

Enfermeria Intensiva Pub Date : 2025-05-22 DOI:10.1016/j.enfi.2025.500551

Alejandro González-Castro MD, pHD , David Iglesias MD , Yhivian Peñasco MD, pHD , Carmen Huertas Marín MD , Elena Cuenca-Fito MD , Trinidad Dierssen-Soto MD, pHD , Reinhard Wallmann MD , Raquel Ferrero-Franco RN , Camilo González MD , Juan Carlos Rodríguez-Borregán MD

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引用次数: 0

摘要

背景与目的covid -19疫苗接种可能改变重症病程，影响出院费用。本研究比较了icu收治的COVID-19患者基于疫苗接种状况的出院费用，并根据所有患者精细诊断相关组（APR-DRG）和严重程度进行了调整。患者和方法回顾性研究（2020年3月- 2022年3月）在ICU进行，将患者分为三组：未接种疫苗、完全接种疫苗和部分接种疫苗。全面疫苗接种包括按疫苗接种计划接种所需的所有剂量和加强剂。疾病严重程度分为轻度、中度、重度和危重。直接住院费用，包括ICU住院、医疗程序、药物和生命支持，使用SAN/35/2017号命令的数据进行分析，并根据通货膨胀进行调整。比较采用卡方检验和Kruskal-Wallis检验，并采用Bonferroni校正。结果共纳入456例患者：未接种疫苗262例（57%），部分接种疫苗32例（7%），完全接种疫苗162例（35%）。中位数成本为：•未接种疫苗：10,653欧元（IQR：€6,160-€18,274）•部分接种疫苗：€17,360 （IQR：€5,061-€26,085）•完全接种疫苗：€10,653 （IQR：€6,160-€26,085）成本差异无统计学意义（P= 0.28）。危重患者的费用最高，轻症患者的费用最低（p < 0.05）。在每个严重程度级别或APR-DRG相对权重中没有发现显著的成本差异（P= 0.38）。结论不同疫苗接种情况下APR-DRG的出院费用无显著差异。然而，疫苗接种可能降低疾病严重程度和对密集资源的需求，对未来的研究具有潜在的经济和临床意义。

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Impacto de la vacunación frente al COVID-19 en los costos hospitalarios en los enfermos ingresados en una unidad de cuidados intensivos durante la cuarta, quinta y sexta oleada de la pandemia

Background and objective

COVID-19 vaccination may alter the course of severe disease and influence hospital discharge costs. This study compares hospital discharge costs among ICU-admitted COVID-19 patients based on vaccination status, adjusted for All Patient Refined Diagnosis Related Groups (APR-DRG) and severity.

Patients and methods

A retrospective study (March 2020-March 2022) was conducted in an ICU, categorizing patients into three groups: unvaccinated, fully vaccinated, and partially vaccinated. Full vaccination included all required doses and boosters per the vaccination schedule. Disease severity was classified as mild, moderate, severe, and critical. Direct hospital costs, including ICU stay, medical procedures, medications, and life support, were analyzed using data from Order SAN/35/2017, adjusted for inflation. Chi-square and Kruskal-Wallis tests with Bonferroni correction were used for comparisons.

Results

A total of 456 patients were included: 262 (57%) unvaccinated, 32 (7%) partially vaccinated, and 162 (35%) fully vaccinated. Median costs were:

•
Unvaccinated: €10,653 (IQR: €6,160-€18,274)
•
Partially vaccinated: €17,360 (IQR: €5,061-€26,085)
•
Fully vaccinated: €10,653 (IQR: €6,160-€26,085)

Cost differences were not statistically significant (P=.28). Critical severity patients had the highest costs, while mild cases had the lowest (P<.05). No significant cost differences were found within each severity level or in APR-DRG relative weight (P=.38).

Conclusions

No significant differences in hospital discharge costs by APR-DRG were found based on vaccination status. However, vaccination may reduce disease severity and the need for intensive resources, with potential economic and clinical implications for future research.

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来源期刊

Enfermeria Intensiva NURSING-

CiteScore

2.50

自引率

23.10%

发文量

期刊介绍： Enfermería Intensiva es el medio de comunicación por antonomasia para todos los profesionales de enfermería españoles que desarrollan su actividad profesional en las unidades de cuidados intensivos o en cualquier otro lugar donde se atiende al paciente crítico. Enfermería Intensiva publica cuatro números al año, cuyos temas son específicos para la enfermería de cuidados intensivos. Es la única publicación en español con carácter nacional y está indexada en prestigiosas bases de datos como International Nursing Index, MEDLINE, Índice de Enfermería, Cuiden, Índice Médico Español, Toxline, etc.