Jonsson Karin, Hedelin Hans
Department of Research and Development, Skaraborgs Sjukhus Skövde, Sweden.
Scand J Urol. 2013 Apr;47(2):113-7. doi: 10.3109/00365599.2012.704941. Epub 2012 Aug 31.
Approximately 8% of nursing home patients in Sweden have a long-term indwelling catheter. A catheter requires daily care and regular changes (basic care). Beyond this, significant numbers of patients are troubled by frequent complications necessitating acute catheter changes and/or rinses. The aim of this study was to calculate the costs associated with long-term indwelling catheters among patients at nursing homes.
All 366 patients with indwelling urinary catheters at 78 nursing homes were followed prospectively for 1 year and all catheter-related procedures, rinses, and changes were registered and the costs of the procedures calculated.
The basic cost was calculated to be SEK 1157 per month and patient. The average monthly cost for acute interventions was estimated to range from SEK 169 in the quartile with few such events up to SEK 455 in the quartile with frequent acute interventions. Personnel accounted for over 90% of the costs associated with indwelling catheters.
Basic catheter care was more cost intensive than acute interventions. This applied even for the 25% of subjects frequently troubled by complications requiring acute catheter changes or rinses. The cost of the catheters and material used in connection with catheter rinses/irrigations was low compared with the cost of the personnel undertaking the procedures.
瑞典约8%的养老院患者长期留置导尿管。导尿管需要每日护理和定期更换(基础护理)。除此之外,大量患者因频繁出现并发症而需要紧急更换导尿管和/或冲洗,深受其扰。本研究的目的是计算养老院患者长期留置导尿管的相关费用。
对78家养老院的366例留置导尿管患者进行了为期1年的前瞻性随访,记录了所有与导尿管相关的操作、冲洗和更换情况,并计算了这些操作的费用。
计算得出每位患者每月的基础费用为1157瑞典克朗。急性干预的平均每月费用估计在四分位数区间内,从很少发生此类事件的169瑞典克朗到频繁发生急性干预的455瑞典克朗不等。人员费用占留置导尿管相关费用的90%以上。
导尿管基础护理比急性干预成本更高。即使对于25%经常因并发症而需要紧急更换导尿管或冲洗的患者也是如此。与进行操作的人员费用相比,导尿管及与导尿管冲洗/灌注相关材料的费用较低。