#头条创作挑战赛#
The content of this article has reliable sources, and the relevant sources are stated at the end of the article, please read it rationally.
[Preface]
Nowadays, many people are complaining that the pressure of life is too great, and they dare not get sick at all, not only to delay work and study, but also to pay a small amount for medical expenses, even if it is just a small illness such as a cold and fever.
And some cancers and tumors, whether in the early or late stages of the disease, the treatment cost is basically astronomical for ordinary people.
Compared with the cost of the intensive care unit, these expenses are a drop in the bucket, and when you enter the intensive care unit, you know what it means to spend money like water.
The daily expenses of the intensive care unit are often tens of thousands, and some patients spend millions of dollars in the ICU for 10 days, and some even spend 2.34 million yuan on 14 days of medical treatment, which is an expenditure of hundreds of thousands every day.
Is the intensive care unit a tool to cure diseases and save lives, or a tool to collect money? Why is there such a big expense?
Tunjindi ICU
Xiao Hao, a high school student in Shenzhen, had red and swollen eyes and involuntary tremors of his hands when he was at school, and was diagnosed with internal jugular vein occlusion and dural arteriovenous fistula when he was admitted to the hospital.
In 2019, Xiao Hao had already undergone surgery in Shenzhen and Beijing respectively, and after the operation, Xiao Hao's condition was relatively stable.
This disease is generally caused by congenitality, and the family at that time sighed that it was fortunate that the timely treatment allowed Xiao Hao to get out of danger, but only two years later, Xiao Hao suddenly fell into a coma.
At the beginning of the operation, the family was mentally prepared because the doctor said that there was no way to cure this disease at one time.
However, because Xiao Hao is still young, I hope that they will consider the first surgery and wait for Xiao Hao to grow up before having follow-up surgery.
In 2019, Xiao Hao underwent two surgeries, coupled with regular re-examinations, his condition was basically stable, but he did not expect that in August 2021, Xiao Hao suddenly fell unconscious.
After being taken to the hospital, he was immediately admitted to the intensive care unit, and had an operation the day after admission, and another at the end of the month, which combined for more than 30 hours.
As early as 2019, Xiao Hao had spent hundreds of thousands of dollars to see a doctor and have surgery, and Xiao Hao's family was not a rich and noble family, but for the sake of the child, his parents had to save him with everything.
But Xiao Hao's hospitalization in 2021, the cost of surgery and the high cost of treatment in the later stage overwhelmed his parents.
This operation is different from two years ago, just imported materials, the cost of the operation exceeded one million, and what made them even more devastated was the cost of the intensive care unit, which added up to 2.34 million yuan in 14 days.
Even if the medical insurance covers 60%, Xiao Hao's family still has to bear nearly one million treatment costs, and later Xiao Hao's matter was reported by the media, and all walks of life extended a helping hand to help Xiao Hao bear part of the cost.
In 14 days, the sky-high medical expenses of 2.34 million yuan, and the average daily expenditure are 1670000 yuan, which is a huge cost that an ordinary family can't imagine.
In order to save his mother's life, the filial son, who spent 1.18 million yuan on 18 days of treatment, took out the money for himself and his wife to buy a wedding house is still not enough.
Someone was admitted to the intensive care unit because of a cold and fever before, and the family members couldn't understand the complicated medical terms at all, the husband Liu Jun could only understand it, and his wife Xu Meihua was sick and her lungs were as hard as a stone.
After his wife was admitted to the intensive care unit, the doctor told Liu Jun that if he wanted to save his life, he would need to use ECMO, or extracorporeal oxygenation of the pulmonary membranes, which can replace the heart and lungs to maintain life.
As long as such an instrument is turned on, it burns money every day, and it is not possible to use it if you have money, and the ECMO of many hospitals in Shanghai at that time was not empty, and finally contacted a hospital in Hangzhou, and the other party had a life-saving ECMO, so Xu Meihua was pulled back from the ghost gate.
And this seemingly inconspicuous fever almost killed Xu Meihua, and they spent 400,000 yuan in the 13 days in the intensive care unit.
As long as you enter the intensive care unit, it is like turning on the faucet of money expenditure, and the money will flow away like running water, and countless ordinary families will be ruined because of this.
This can't help but make people wonder what the purpose of the existence of the intensive care unit is, why do you need so much money to treat diseases and save people, what kind of people want to live in the intensive care unit, and who don't use it?
Who is going to be in the ICU
Generally, patients admitted to the intensive care unit basically meet three indications, the first is high-risk patients.
Some patients who have undergone major surgery, are unconscious after surgery, or even have organ failure, need to receive close monitoring and treatment in the intensive care unit because of many life-threatening high-risk factors.
The second type is patients who can recover in a short period of time, patients with acute reversible diseases, shock for various reasons, accidental trauma or acute severe patients.
The third type is the original chronic disease, but later acute attack or exacerbation, such patients are due to the original chronic disease, organ dysfunction, so the acute attack or exacerbation may be life-threatening, also need to be admitted to the intensive care unit.
But not all seemingly critical situations require admission to the intensive care unit, such as the acute onset of some chronic diseases.
It is true that a small number of such patients need to be admitted to the intensive care unit, but in many cases, after the onset of chronic diseases, those who do not have shock or organ failure can be effectively managed in the general ward.
There are also some surgeries in which not all patients are admitted to the intensive care unit after surgery, and patients who do not involve major organs, who are recovering well after surgery, and who are not at risk of major life-threatening complications, may also be admitted to a general ward.
Doctors also only know what an intensive care unit means, and when making decisions, they also take into account the patient's condition, potential risks, and treatment options to try to ensure that the patient can be treated in the right environment.
After all, no one wants to be admitted to an intensive care unit and be monitored 24 hours a day, not to mention that the cost of an intensive care unit is too high.
Why is it so expensive?
For patients, hospitals are the guarantee of health, and intensive care units, for those who are dying, are the last line of defense for life.
Of course, everything has a price, and the intensive care unit is the last hurdle against illness and pain when medical means are used to save the patient's life.
Correspondingly, the price of intensive care units is high, and the fees are so expensive, which may be unacceptable for patients and their families, while for hospitals, these charges are actually within a reasonable range, and they are not a means of making money.
The first reason for the high cost of intensive care units is medicines, and patients who need to be admitted to the intensive care unit are at risk.
In patients who are dying, it is not only because of the clinical reaction caused by the disease, but also because of the important point, that is, serious infection.
Whether it's a patient who has undergone a major surgery or is admitted to the intensive care unit after an accident, one of the most life-threatening factors for them is infection.
If you want to stabilize the patient's situation in this situation, you need to use anti-infective drugs or hormones, many drugs are imported, not included in the medical insurance, and the patient can only pay for it.
The second is the cost of nursing staff, and patients in the intensive care unit basically need to be supervised and cared for for a long time.
In the intensive care unit, the number of family visits per day is very limited, but the patient's condition here is urgent and changes very quickly, so professionals are required to accompany them almost 24 hours a day.
The workload and difficulty of this profession are not comparable to those of ordinary clinical departments, so each intensive care unit ward needs to be equipped with more doctors and nurses on call than ordinary wards.
The work of nursing staff is also more tedious and difficult than that of nurses in general wards, so the cost of nursing staff is also a relatively large expense.
The third item is the cost of examination, and patients in intensive care units are usually very complex, otherwise they would not have required 24-hour monitoring.
Such patients need to do a variety of tests if they want to follow up on the changes in their condition at any time, and many of them are not enough to do at one time.
Nowadays, many examinations, such as blood, biochemistry, imaging and other examinations, are not cheap, and there are many patients in the intensive care unit, so the cost is naturally more expensive.
The last and most important item is the cost of using the equipment, and the most different thing about the intensive care unit from the general ward is the various life-sustaining equipment.
Monitors, ventilators, hemodialysis machines, and the aforementioned ECMO are not always available, but they are not cheap to use.
One of the most frequently mentioned expensive devices is ECMO, extracorporeal membrane oxygenation, which can replace cardiopulmonary function for cardiopulmonary bypass, so it is also called an artificial heart-lung machine.
However, although ECMO can maintain the patient's life, due to the expensive disposable consumables involved, it will cost tens of thousands of yuan just to start and operate.
The start-up and operation cost of different brands of ECMO is different, but basically it is between 25,000 yuan and 70,000 yuan, which is only the cost of turning on this equipment.
After that, although it will not be as expensive as booting, the daily cost is basically tens of thousands of yuan, because ECMO is not only expensive, but also the cost of continuous use is quite amazing.
In fact, the state has been trying its best to solve the situation that the cost of intensive care units is difficult for ordinary people to afford.
The latest opinion issued by the National Health Commission is to clearly include the price of critical care medical into the dynamic adjustment mechanism.
According to the website of the National Health Commission on May 6, eight departments including the National Health Commission issued the "Opinions on Strengthening the Capacity Building of Critical Medical Services" (hereinafter referred to as the "Opinions"). The "Opinions" put forward that the price of critical medical services should be reasonably adjusted.
Include the price of critical medical services in the dynamic adjustment mechanism for overall consideration, and where the conditions for initiation are met, priority is given to medical service items that reflect the characteristics and value of critical medical technology and labor services, such as those with high technical difficulty, high risk, and high resource consumption, into the scope of price adjustment, and reasonable price adjustments are to be formulated.
We should do a good job in the convergence of policies such as price adjustment, medical insurance payment and medical fee control, so as to ensure that the burden of basic medical expenses on patients does not increase overall.
end
For patients who do not meet the indications, doctors certainly do not admit them to intensive care units that burn money all the time in order to generate income.
Of course, the treatment will respect the opinions of patients and their families, and I hope that in the future, the treatment cost of intensive care units can be effectively reduced, so that patients' families will not be allowed to endure the torment of choosing high treatment costs and the lives of their loved ones.
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END
Resources
On May 7, 2024, Guangming.com reported on "The price of critical medical services is included in the dynamic adjustment mechanism to ensure that the burden of basic medical expenses on patients does not increase overall".
On December 19, 2019, The Paper published "13 days ICU spent 400,000 yuan and listed two suites, why can a cold kill someone?" ".
On September 14, 2021, Beiqing.com published "A 17-year-old boy in Shenzhen suddenly fell into a coma! The treatment cost millions, and the first sentence of waking up made people cry".