家庭治疗与住院治疗的成本比较分析

Comparative cost analysis of home and hospital treatment.

作者信息

Vinciguerra V, Degnan T J, Budman D R, Brody R S, Moore T, Sciortino A, O'Connell M

出版信息

Prog Clin Biol Res. 1986;216:155-64.

Abstract

A comparative study evaluating home and hospital treatment for terminal cancer patients is reported. Home care was provided by a comprehensive home care program, the Don Monti Home Oncology Medical Extension (H.O.M.E.). A multispecialty team including an oncologist, oncology nurse, social worker, dietitian and technologist is transported to the home in a medically-equipped van to render treatment. Services provided include physical assessments, pain control, chemotherapy and transfusion administration, psychosocial support, nutrition education and bereavement counseling. Two-hundred eighteen patients were entered of which 174 were treated at home and 44 in the hospital. Patients were comparable in age, diagnosis, sites of metastases, prior treatment and Karnofsky status. Both groups received similar supportive care either at home or in the hospital. Cost analysis of home and hospital care revealed a per diem cost benefit of $256.00 for home treatment. Comprehensive home treatment provided by a multi-specialty team can deliver effective care with medical and financial benefits to terminal cancer patients.

摘要

本文报告了一项针对晚期癌症患者在家治疗与住院治疗的对比研究。居家护理由一个综合性居家护理项目——唐·蒙蒂家庭肿瘤医学拓展项目（H.O.M.E.）提供。一个由肿瘤学家、肿瘤护士、社会工作者、营养师和技术专家组成的多专业团队乘坐配备医疗设备的厢式货车前往患者家中进行治疗。提供的服务包括身体评估、疼痛控制、化疗和输血管理、心理社会支持、营养教育以及临终关怀咨询。共有218名患者参与研究，其中174名在家接受治疗，44名在医院接受治疗。患者在年龄、诊断、转移部位、既往治疗情况和卡氏评分状态方面具有可比性。两组患者在家庭或医院均接受了类似的支持性护理。对居家护理和住院护理的成本分析显示，居家治疗每天可节省成本256美元。由多专业团队提供的综合性居家治疗能够为晚期癌症患者提供有效的护理，并带来医疗和经济效益。