丹麦市政府家庭医院微型成本的可行性:一项前性试点研究
Nasrin Tayyari1,2, Iben Duvald3,4, Malene Galle Madsen5
1Public Health & Quality Improvement Aarhus N, DK, DEFACTUM, Aarhus, Denmark nastay@rm.dk.
BMJ open
|December 25, 2025
概括
微成本成功地确定了在家庭医院模型中的资源使用情况,创建了用于关税发展的数据集. 这项可行性研究为未来对家庭护理的经济评估提供了基础.
科学领域:
- 医疗保健经济学 医疗保健经济学
- 医疗服务研究 医疗服务研究
- 成本分析 成本分析
背景情况:
- 家庭医院 (HaH) 模式提供了传统医院护理的替代方案.
- 准确的资源利用数据对于经济评估和HH环境中的关税发展至关重要.
- 丹麦市政府正在探索HaH模型,需要可行的资源量化方法.
研究的目的:
- 评估微成本计算的可行性,以识别和量化市政家庭医院 (HaH) 模型中的资源使用情况.
- 创建医疗保健提供者活动和时间的透明数据集.
- 以时间驱动的基于活动的成本计算来支持关税的发展,并为正在进行的随机对照试验 (RCT) 的经济评估提供信息.
主要方法:
- 在三个丹麦市镇进行了前性试点可行性研究.
- 微成本数据收集的重点是可行性 (完整性,一致性,可接受性) 和描述性资源使用量.
- 在试点阶段收集了56名老年急性患者的数据,这些患者在HaH模型中接受治疗.
主要成果:
- 患者平均接受3.8个HaH治疗日,每次7.8次急症团队访问和3.9次市政工作人员访问.
- 急性小组平均每位患者花费了742分钟,而市政护理人员花费了213分钟.
- 通过共同设计和反,数据的完整性和一致性在试点中得到了改善,静脉注射药物和生命体征评估是最常见的活动.
结论:
- 通过提供商日志进行详细的资源使用测量在市政HaH模型中是可行的,从而产生适合制定关税的数据集.
- 在试点期间完善的微成本计算方法将在RCT中应用,用于使用基于时间驱动的基于活动的成本计算来构建价格.
- 结果是特定于环境的,由于样本规模较小,无法概括;需要在不同的环境中进行进一步研究.
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