Witt Julia, Brauer Paula, Dietrich Linda, Davidson Bridget
Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Melbourne, Australia.
Can J Diet Pract Res. 2006 Autumn;Suppl:S30-8. doi: 10.3148/67.0.2006.s30.
Information on human resources and costs is needed to plan for the addition of registered dietitian (RD) services to new models of primary health care (PHC). Estimates were developed, based on an analysis of an enhanced RD model of counselling and health promotion services in three Ontario Family Health Networks (FHNs).
Both direct and indirect costs were averaged over the three FHNs. Costs and RD activities were tracked throughout 2005. The FHN staff completed two questionnaires addressing communication, case management, and satisfaction with RD services.
Actual and reported case management indicated that an estimated 1.3% to 2.4% of the 60,000 enrolled patients may require individual nutrition counselling in a year. If one full-time equivalent (FTE) RD can manage 380 new referrals, then one FTE RD is needed per 15,800 to 29,000 patients. The estimated direct costs of adding one FTE RD (including expenses and fixed costs) is US dollars 78,169 to US dollars 80,169, when the RD is an independent contractor.
Additional studies are needed to develop better estimates of human resource needs and costs of interdisciplinary nutrition services in all PHC settings. These estimates should be based on population characteristics and direct and indirect costs for all models of nutrition services in PHC settings.
为规划将注册营养师（RD）服务纳入新型初级卫生保健（PHC）模式，需要有关人力资源和成本的信息。基于对安大略省三个家庭健康网络（FHN）中强化的RD咨询与健康促进服务模式的分析得出了相关估计。
对三个FHN的直接和间接成本进行平均计算。在2005年全年跟踪成本和RD活动。FHN工作人员完成了两份关于沟通、病例管理以及对RD服务满意度的问卷。
实际和报告的病例管理表明，在60,000名登记患者中，估计每年有1.3%至2.4%的患者可能需要个体营养咨询。如果一名全职等效（FTE）的RD能够处理380个新转诊病例，那么每15,800至29,000名患者就需要一名FTE的RD。当RD为独立承包商时，增加一名FTE RD的估计直接成本（包括费用和固定成本）为78,169美元至80,169美元。
需要进行更多研究，以便更准确地估计所有初级卫生保健环境中跨学科营养服务的人力资源需求和成本。这些估计应基于人口特征以及初级卫生保健环境中所有营养服务模式的直接和间接成本。
