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英格兰体弱老年人的正规护理成本:医学研究理事会认知功能与衰老研究的资源影响研究(医学研究理事会认知功能与衰老研究资源影响研究)

Costs of formal care for frail older people in England: the resource implications study of the MRC cognitive function and ageing study (RIS MRC CFAS).

作者信息

McNamee P, Gregson B A, Buck D, Bamford C H, Bond J, Wright K

机构信息

Centre for Health Services Research, School of Health Sciences, University of Newcastle upon Tyne, UK.

出版信息

Soc Sci Med. 1999 Feb;48(3):331-41. doi: 10.1016/s0277-9536(98)00351-7.

Abstract

The aim of this paper is to quantify service use and costs of supporting frail older people at home in the community, using data collected in a longitudinal multicentre stratified randomised study for 1055 mentally frail, physically frail, and mentally and physically frail subjects. Average costs per person per week were found to total 64.45 Pounds Sterling, with a small number of services accounting for a large proportion of the total costs. The level of services offered by the nonstatutory voluntary and private sectors was found to be small. To highlight issues for policy makers, the extent of cost variations between a number of different subgroups were calculated. These bivariate analyses revealed substantial variation in costs, especially according to household structure, type of frailty, whether admission to continuing care accommodation occurred and survival. Multiple regression analysis demonstrated that 26% of the variation in log average weekly costs could be explained by a number of socio-demographic and health status variables. A particularly close relationship was observed between costs and whether admission to continuing care accommodation occurred, highlighting a need for policy-makers to examine the nature and scale of provision of alternative community based care packages. The results demonstrate that descriptive cost data such as those presented can provide information useful to the planning process, enabling more informed choices to be made over the provision of services for particular groups of people.

摘要

本文旨在利用一项针对1055名精神虚弱、身体虚弱以及精神和身体都虚弱的受试者开展的纵向多中心分层随机研究中收集的数据,对社区中在家照料体弱老年人的服务使用情况及成本进行量化。结果发现,每人每周的平均成本总计64.45英镑,少数服务占总成本的很大比例。非法定志愿部门和私营部门提供的服务水平较低。为向政策制定者强调相关问题,计算了多个不同亚组之间的成本差异程度。这些双变量分析显示成本存在显著差异,尤其是根据家庭结构、虚弱类型、是否入住持续护理机构以及存活情况来看。多元回归分析表明,对数平均每周成本26%的差异可由一些社会人口学和健康状况变量来解释。成本与是否入住持续护理机构之间存在特别密切的关系,这突出表明政策制定者需要审视基于社区的替代护理套餐的提供性质和规模。结果表明,像本文所呈现的描述性成本数据可为规划过程提供有用信息,从而能就为特定人群提供服务做出更明智的选择。

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