Haggerty M C, Stockdale-Woolley R, Nair S
Section of Pulmonary Medicine, Norwalk Hospital, CT 06856.
Chest. 1991 Sep;100(3):607-12. doi: 10.1378/chest.100.3.607.
The purpose of the present study was to evaluate the effectiveness of a hospital-based home care program for a group of patients with severe COPD. Respi-Care was a multidisciplinary home care program administered by Norwalk Hospital in cooperation with the public health nursing departments of the city of Norwalk and the town of Wilton, Conn. The overall goal of Respi-Care was to provide more comprehensive home care services to patients previously requiring frequent hospitalizations by combining the advantages of hospital resources and community agencies through a unique cooperative effort. Preprogram and on-program data were collected on the following variables for the 48 months of Respi-Care operation: hospitalizations; hospital days; emergency room visits; home care services; and the costs of these services. Costs of operating the Respi-Care program were included in on-program data. Seventeen subjects completed 320.5 months on Respi-Care. Each subject was matched to an equal length of time prior to entering the program, for a total of 641 months analyzed. There were 88 preprogram hospitalizations for the group; hospitalizations while participating in Respi-Care dropped to 53 (p = 0.022; paired t statistics). On-program hospital days showed a significant decrease, from 1,181 preprogram days to 667 on-program days (p = 0.024). Emergency room visits decreased from 105 before the program to 64 during the program (p = 0.017). Costs of care also decreased. Costs for hospitalizations, emergency room visits, and home care fell from $908,031 to $802,999, resulting in a $105,032 savings or $328 per patient per month.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究的目的是评估一项基于医院的居家护理项目对一组重度慢性阻塞性肺疾病（COPD）患者的有效性。呼吸护理（Respi-Care）是由诺沃克医院与康涅狄格州诺沃克市和威尔顿镇的公共卫生护理部门合作实施的多学科居家护理项目。呼吸护理的总体目标是通过独特的合作努力，结合医院资源和社区机构的优势，为以前需要频繁住院的患者提供更全面的居家护理服务。在呼吸护理项目运行的48个月期间，针对以下变量收集了项目实施前和实施期间的数据：住院情况、住院天数、急诊就诊次数、居家护理服务以及这些服务的费用。呼吸护理项目的运营成本包含在项目实施期间的数据中。17名受试者在呼吸护理项目上共接受了320.5个月的护理。每个受试者在进入该项目之前都匹配了相同时长的时间段，总共分析了641个月。该组在项目实施前有88次住院；参与呼吸护理项目期间住院次数降至53次（p = 0.022；配对t检验）。项目实施期间的住院天数显著减少，从项目实施前的1181天降至项目实施期间的667天（p = 0.024）。急诊就诊次数从项目实施前的105次降至项目实施期间的64次（p = 0.017）。护理费用也有所下降。住院、急诊就诊和居家护理的费用从908,031美元降至802,999美元，节省了105,032美元，即每位患者每月节省328美元。（摘要截选至250字）
