Roberts J, Sword W, Watt S, Gafni A, Krueger P, Sheehan D, Soon-Lee K
School of Nursing, Department of Clinical Epidemiology and Biostatistics, System-Linked Research Unit on Health and Social Service Utilization, McMaster University, Hamilton, Ontario, Canada.
Can J Nurs Res. 2001 Jun;33(1):19-34.
A cross-sectional survey of 1,250 mothers of "normal" newborn infants was conducted to assess mother and infant characteristics as well as the costs of health and social services used in the first 4 weeks after discharge from hospital in the province of Ontario, Canada. Each mother was asked to recall use of services for herself and her infant. This utilization was multiplied by the unit cost of each service and summed to arrive at the total cost of services used. Although re-admission rates were low (1% for mothers, 4% for infants), costs associated with hospital and emergency room care ($194 on average per mother/infant dyad) accounted for the greatest proportion of total health-care costs. Physician or midwife visits, which were received by almost all mothers, were the next most costly service ($128 on average per dyad). Mothers with incomes under $20,000 had more medical costs than those with higher incomes. Costs of community nursing care ($86 on average per dyad) were higher for mothers with more than 5 self-identified learning needs (e.g., infant feeding, infant care and behaviour, emotional changes in self, signs of illness in infant); perception of their own health as poor; perception of inadequate help and support at home; many signs and symptoms of depression; and postpartum hospital stay of 48 hours or less. Costs for social work visits were higher for mothers with depression and mothers with low incomes. Total health and social service costs were double for mothers with family incomes under $20,000 ($788 vs. $399 on average per dyad) and for mothers with clinical depression ($845 vs. $413). Specifically, nursing care costs were greater for mothers with high depression scores ($135 vs. $81).
对1250名“正常”新生儿的母亲进行了一项横断面调查，以评估母亲和婴儿的特征，以及加拿大安大略省出院后头4周内使用的健康和社会服务成本。每位母亲被要求回忆自己和婴儿使用服务的情况。这种使用情况乘以每项服务的单位成本，然后相加得出使用服务的总成本。尽管再入院率较低（母亲为1%，婴儿为4%），但与医院和急诊室护理相关的成本（平均每对母婴194美元）在医疗保健总成本中占比最大。几乎所有母亲都接受的医生或助产士家访是其次成本最高的服务（平均每对母婴128美元）。收入低于20000美元的母亲比收入较高的母亲医疗成本更高。对于有5项以上自我认定学习需求（如婴儿喂养、婴儿护理与行为、自身情绪变化、婴儿疾病迹象）、认为自己健康状况差、认为在家中得到的帮助和支持不足、有许多抑郁症状以及产后住院48小时或更短时间的母亲，社区护理成本（平均每对母婴86美元）更高。患有抑郁症的母亲和低收入母亲的社会工作家访成本更高。家庭收入低于20000美元的母亲（平均每对母婴788美元对399美元）和患有临床抑郁症的母亲（平均每对母婴845美元对413美元）的健康和社会服务总成本是两倍。具体而言，抑郁评分高的母亲护理成本更高（135美元对81美元）。
