治疗目标表明息护理医院费用:一项纵向经济研究
Monika Hagemann1, Barbara Janina Kidszun1, Matthias Schwenkglenks2,3
1University Centre for Palliative Care, Bern University Hospital, University of Bern, Bern, Switzerland.
Swiss medical weekly
|June 1, 2025
概括
一个根据治疗目标对息治疗患者进行分类的新框架揭示了显著的成本差异. 广泛的息治疗 (类型1) 总体上是最昂贵的,而临终患者的护理 (类型4) 的每日费用最高,主要是与工作人员相关的.
科学领域:
- 卫生经济学 卫生经济学
- 抚慰性护理医学 抚慰性护理医学
- 医院管理局 医院管理局
背景情况:
- 研究了住院息护理费用,但患者的需求有很大差异.
- 根据治疗目标对患者进行分类的框架可以帮助理解成本异质性.
- 专业息护理 (SPC) 的成本受到不同患者需求的影响.
研究的目的:
- 确定基于治疗目标的护理类型框架是否反映了SPC中不同患者需求的成本.
- 分析瑞士大学医院不同类型息护理的成本差异.
主要方法:
- 使用行政数据对医院费用 (2016-2022) 的回顾性观察分析.
- 根据治疗目标 (例如,症状管理,终身护理) 将患者分为四种护理类型.
- 一般化的线性模型与反向概率权重用于调整患者特征.
主要成果:
- 总的中位成本因护理类型而异,1型 (广泛需求) 为23999瑞士法郎,4型 (临终患者) 为14997瑞士法郎.
- 调整后的总体成本为1型的最高 (25,827瑞士法郎),为4型的最低 (21,908瑞士法郎).
- 第4类护理人员的每日费用最高 (2361瑞士法郎),主要由护理人员费用 (88%的每日费用) 驱动.
结论:
- 在护理类型中体现出的明确的治疗目标,为了解SPC医院成本提供了关键的框架.
- 专门的息护理单位的患者表现出与他们分配的护理类型直接相关的显著成本变化.
- 该框架有效地解释了成本差异,并强调了员工对终身护理成本的影响.
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