Drew Philip, Posnett John, Rusling Louise
Hull and East Yorkshire Hospitals NHS Trust, Anlaby Road, Hull, HU 3 2J2, UK.
Int Wound J. 2007 Jun;4(2):149-55. doi: 10.1111/j.1742-481X.2007.00337.x.
The objective of this study is to estimate the cost of wound care in a local population of approximately 590 000 using results from a wound care audit carried out in Hull and the East Riding of Yorkshire as a basis. Full results of the audit will be published separately. An audit in June 2005 provided information on patients with wounds and on their treatment. This was combined with representative National Health Service unit costs to produce an estimate of the total cost of wound care in 2005-2006. In all, 1644 patients had a total of 2300 wounds (1.44 per patient). Most (74.1%) were treated in the community by district nurses, 21.2% were treated in hospital and 4.8% were treated in residential or hospice care. More than one in four hospital inpatients (26.8%) had a wound. Median duration was 6-12 weeks. Twenty-four per cent had their wound for 6 months or more, and almost 16% of patients had remained unhealed for a year or longer. One in eight wounds (12.8%) were reported as showing signs of infection. The estimated cost of wound care in 2005-2006 was pound15 million to pound18 million ( pound2.5 million to pound3.1 million per 100 000 population). Caring for patients with wounds required the equivalent of 88.5 full-time nurses and up to 87 hospital beds. Wounds are a significant source of cost to patients as well as the health care system. The most important determinant of cost appears to be wound complications which require hospitalisation or which delay hospital discharge. Reducing costs requires a systematic focus on effective and timely diagnosis, on ensuring treatment is appropriate to the cause and condition of the wound and on active measures to prevent complications and wound-related hospitalisation. These results should be generalisable to other similar populations in the UK and elsewhere.
本研究的目的是,以在赫尔市及约克郡东区开展的伤口护理审计结果为基础,估算当地约59万人口的伤口护理成本。审计的完整结果将另行公布。2005年6月进行的一次审计提供了有关伤口患者及其治疗情况的信息。将这些信息与具有代表性的国民医疗服务体系单位成本相结合,得出了2005 - 2006年伤口护理总成本的估算值。总共有1644名患者,共有2300处伤口(平均每名患者1.44处)。大多数伤口(74.1%)由社区护士在社区进行治疗,21.2%在医院接受治疗,4.8%在养老院或临终关怀机构接受治疗。超过四分之一的住院患者(26.8%)有伤口。伤口的中位持续时间为6至12周。24%的患者伤口持续时间达6个月或更长,近16%的患者伤口一年或更长时间未愈合。八分之一的伤口(12.8%)报告有感染迹象。2005 - 2006年伤口护理的估算成本为1500万至1800万英镑(每10万人口250万至310万英镑)。护理伤口患者需要相当于88.5名全职护士的人力以及多达87张病床。伤口对患者和医疗保健系统而言都是一项重大成本来源。成本的最重要决定因素似乎是需要住院治疗或导致出院延迟的伤口并发症。降低成本需要系统地专注于有效且及时的诊断,确保治疗与伤口的病因和状况相适配,并采取积极措施预防并发症和与伤口相关的住院治疗。这些结果应能推广至英国及其他地区的其他类似人群。