Hospital Admissions, Transfers and Costs of Guillain-Barre Syndrome

Autor: Ann M. Vanrolleghem, Miriam C. J. M. Sturkenboom, Pieter A. van Doorn, Hester F. Lingsma, Nikki van Leeuwen, Bart C. Jacobs, Ewout W. Steyerberg
Přispěvatelé: Public Health, Medical Informatics, Neurology, Immunology
Rok vydání: 2016
Předmět:
Male
Pediatrics
Neurology
Hospitalized patients
Cost-Benefit Analysis
lcsh:Medicine
Developmental and Pediatric Neurology
Geographical Locations
Families
Patient Admission
0302 clinical medicine
Medicine and Health Sciences
Medicine
Public and Occupational Health
030212 general & internal medicine
lcsh:Science
Children
Netherlands
Multidisciplinary
Guillain-Barre syndrome
Clinical course
Cost-effectiveness analysis
Middle Aged
Hospitals
Icu admission
Europe
Intensive Care Units
Female
Research Article
Adult
Patient Transfer
medicine.medical_specialty
Disabilities
Severe disease
Guillain-Barre Syndrome
03 medical and health sciences
Disease severity
Diagnostic Medicine
Humans
business.industry
lcsh:R
medicine.disease
Health Care
Health Care Facilities
Age Groups
People and Places
lcsh:Q
Population Groupings
business
030217 neurology & neurosurgery
Zdroj: PLoS ONE
PLoS One (print), 11(2). Public Library of Science
PLoS ONE, Vol 11, Iss 2, p e0143837 (2016)
ISSN: 1932-6203
Popis: textabstractBackground Guillain-Barre syndrome (GBS) has a highly variable clinical course, leading to frequent transfers within and between hospitals and high associated costs. We defined the current admissions, transfers and costs in relation to disease severity of GBS. Methods Dutch neurologists were requested to report patients diagnosed with GBS between November 2009 and November 2010. Information regarding clinical course and transfers was obtained via neurologists and general practitioners. Results 87 GBS patients were included with maximal GBS disability score of 1 or 2 (28%), 3 or 4 (53%), 5 (18%) and 6 (1%). Four mildly affected GBS patients were not hospital admitted. Of the 83 hospitalized patients 68 (82%) were initially admitted at a neurology department, 4 (5%) at an ICU, 4 (5%) at pediatrics, 4 (5%) at pediatrics neurology and 3 (4%) at internal medicine. Median hospital stay was 17 days (IQR 11-26 days, absolute range 1-133 days). Transfers between departments or hospitals occurred in 33 (40%) patients and 25 (30%) were transferred 2 times or more. From a cost-effectiveness perspective 21 (25%) of the admissions was suboptimal. Median costs for hospital admission of GBS patients were 15,060 Euro (IQR 11,226-23,683). Maximal GBS disability score was significantly correlated with total length of stay, number of transfers, ICU admission and costs. Conclusions Hospital admissions for GBS patients are highly heterogeneous, with frequent transfers and higher costs for those with more severe disease. Future research should aim to develop prediction models to early identify the most cost-effective allocation in individual patients.
Databáze: OpenAIRE
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