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为避免锐器相关伤害而支付费用的意愿:一项针对受伤医护人员的研究。

Willingness to pay to avoid sharps-related injuries: a study in injured health care workers.

作者信息

Fisman David N, Mittleman Murray A, Sorock Gary S, Harris Anthony D

机构信息

City of Hamilton Social and Public Health Services Department, Ontario, Canada.

出版信息

Am J Infect Control. 2002 Aug;30(5):283-7. doi: 10.1067/mic.2002.124586.

Abstract

BACKGROUND

Injuries caused by sharp medical devices are common among health care workers and may result in the transmission of human immunodeficiency virus and hepatitis C virus.

OBJECTIVE

The direct medical costs associated with treating these injuries are well characterized but fail to capture the costs of such intangible factors as worker anxiety and distress. The objective of this study was to estimate these intangible costs.

SUBJECTS

Subjects included health care workers reporting sharps-related injuries to 2 hospital occupational health services.

METHOD

A contingent valuation approach was used to assess willingness to pay to avoid sharps-related injuries among recently injured health care workers. Workers were presented with the option of paying out of pocket for a hypothetical injury-prevention device. The median amount of money subjects were willing to pay was estimated with logistic regression, and multivariable regression was performed to assess confounding by worker characteristics and circumstances surrounding injuries.

RESULTS

Study interviews were conducted for 116 subjects; median time from injury to interview was 3 days (range, 0-15). Most subjects were women (73%), and most were nurses (44%) or trainees (32%). The crude median amount subjects were willing to pay to avert injury was $850 (US); when adjusted for patient risk status (human immunodeficiency virus and hepatitis C virus status), and working with an uncooperative patient at the time of injury, median amount increased to $1270.

CONCLUSION

The high median amount subjects were willing to pay to avoid a sharps-related injury suggests that the costs of "intangible" aspects of worker injury, such as anxiety and distress, may equal costs associated with the medical evaluation of these injuries. These costs should be incorporated in economic analyses of sharps-injury prevention.

摘要

背景

锐器所致伤害在医护人员中很常见,可能导致人类免疫缺陷病毒和丙型肝炎病毒的传播。

目的

治疗这些伤害的直接医疗费用已有充分描述,但未涵盖诸如工作人员焦虑和痛苦等无形因素的成本。本研究的目的是估计这些无形成本。

对象

对象包括向两家医院职业健康服务部门报告锐器相关伤害的医护人员。

方法

采用条件估值法评估近期受伤的医护人员为避免锐器相关伤害而愿意支付的费用。向工作人员提供自费购买一种假设的伤害预防装置的选择。用逻辑回归估计受试者愿意支付的金钱中位数,并进行多变量回归以评估工作人员特征和伤害周围情况的混杂因素。

结果

对116名受试者进行了研究访谈;从受伤到访谈的中位时间为3天(范围0 - 15天)。大多数受试者为女性(73%),大多数是护士(44%)或实习生(32%)。受试者为避免受伤愿意支付的粗略中位数金额为850美元(美国);在根据患者风险状况(人类免疫缺陷病毒和丙型肝炎病毒状况)以及受伤时与不合作患者一起工作进行调整后,中位数金额增加到1270美元。

结论

受试者为避免锐器相关伤害而愿意支付的高额中位数表明,工作人员受伤的“无形”方面的成本,如焦虑和痛苦,可能与这些伤害的医学评估相关成本相当。这些成本应纳入锐器伤害预防的经济分析中。

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