Birenbaum L K, Clarke-Steffen L
Pediatr Nurs. 1992 May-Jun;18(3):285-8.
To present a conceptualization of health care costs and to describe costs of health care in the terminal phase of childhood cancer. To present an exploratory comparison of the costs of terminal care in the hospital versus home care services, and to discuss the use of cost research in nursing practice.
Telephone interviews were done approximately 16 months after the death of a child to retrospectively ascertain services used, costs to the family, and insurance information. Provider billing and insurance data were subsequently collected. The families were divided into two groups based upon the use of home care or traditional hospital care during the terminal phase.
Home care was less expensive for total costs than hospital care. Home care was more expensive for nonhealth care and indirect costs than hospital care.
Nurses should consider direct health care costs, nondirect health care costs, and indirect costs when assisting family decisions about care. Nurses and families should be aware of potential cost shifting.
提出医疗保健成本的概念，并描述儿童癌症终末期的医疗保健成本。对医院终末期护理成本与家庭护理服务成本进行探索性比较，并讨论成本研究在护理实践中的应用。
在儿童死亡约16个月后进行电话访谈，以回顾性确定所使用的服务、家庭成本以及保险信息。随后收集提供者计费和保险数据。根据终末期是否使用家庭护理或传统医院护理，将家庭分为两组。
家庭护理的总成本低于医院护理。家庭护理的非医疗保健和间接成本高于医院护理。
护士在协助家庭做出护理决策时，应考虑直接医疗保健成本、非直接医疗保健成本和间接成本。护士和家庭应意识到潜在的成本转移。
