Pompeo M Q
Wound Care Center, IHS Hospital of Dallas, 7955 Harry Hines Blvd., Dallas, TX 75235, USA.
Ostomy Wound Manage. 2001 Mar;47(3):65-71.
Because of the tremendous resources they require to heal, patients with severe wounds present significant challenges to our healthcare system. This study was undertaken to introduce the concept of "wound burden" and its predictive value in anticipating the costs associated with inpatient care for patients with wounds. Wound burden is a new concept that can be used to represent the severity of a patient's skin breakdown; it is defined in this study in terms of number, size, and stage. A computerized system of wound cost tracking measured the costs involved in delivering optimal wound care to 240 patients in a long-term acute care facility. Patients were stratified in a system that accounted for "wound burden" to determine the degree to which wound burden is related to costs. Costs that pertained to supplies, specialty beds, nutrition, labs, and extra personnel time required to document and care for the wounds were recorded. The concept of "wound burden" was presented and found to be very important in predicting actual costs. Patients with the highest level of wound burden were found to have significantly higher wound costs and total stay costs (P > 0.0001). As payment systems change, having data available to justify the resources necessary to allow facilities to continue to care for the most highly wound burdened patients will become increasingly important.
由于严重伤口的愈合需要巨大资源，重症伤口患者给我们的医疗系统带来了重大挑战。本研究旨在引入“伤口负担”的概念及其在预测伤口患者住院护理相关成本方面的预测价值。伤口负担是一个可用于表示患者皮肤破损严重程度的新概念；本研究根据数量、大小和阶段对其进行定义。一个伤口成本跟踪计算机系统测量了为一家长期急性护理机构的240名患者提供最佳伤口护理所涉及的成本。患者被纳入一个考虑“伤口负担”的系统进行分层，以确定伤口负担与成本的相关程度。记录了与伤口护理所需的用品、特殊病床、营养、实验室检查以及记录和护理伤口所需的额外人员时间相关的成本。“伤口负担”的概念被提出并发现对预测实际成本非常重要。伤口负担水平最高的患者被发现伤口成本和总住院成本显著更高（P>0.0001）。随着支付系统的变化，获取数据以证明设施继续护理伤口负担最重患者所需资源的合理性将变得越来越重要。
