Company-Sancho María Consuelo, Estupiñán-Ramírez Marcos, Sánchez-Janáriz Hilda, Tristancho-Ajamil Rita
Servicio de Atención Primaria, Dirección General de Programas Asistenciales, Servicio Canario de la Salud, Las Palmas de Gran Canaria, España.
Servicio de Atención Primaria, Dirección General de Programas Asistenciales, Servicio Canario de la Salud, Las Palmas de Gran Canaria, España.
Enferm Clin. 2017 Jul-Aug;27(4):214-221. doi: 10.1016/j.enfcli.2017.04.002. Epub 2017 May 10.
The health service invests up to 75% of its resources on chronic care where the focus should be on caring rather than curing. Nursing staff focuses their work on such care. Care requires being redorded in health histories through the standardized languages. These records enable useful analyses to organisational and healthcare decision-making. Our proposal is to know the association of between nursing diagnosis and a higher total expenditure on health.
An observational cross-sectional analytical study was performed based on data from electronic health records in Primary Care (Drago-AP), hospital discharges (CMBD-AH) and prescriptions (REC-SCS) of patients over 50 from 2012-2013 in the Canary Islands. A descriptive, bivariate and multivariate analysis was undertaken to create a predictive model on the use of resources.
Sociodemographic (age, sex, type of health-care affiliation, type of prescription charge) and nursing diagnosis (ND) recorded in late 2012. Dependent variables: Resources consumed in 2013.
582,171 patients met the criteria for inclusion. 53.0% of them were women with an average age of 64.3 years (SD 10.8years). 53.2% were pensioners. 49% of the included population had an ND, with an average of 2.1ND per patient. The average costs per patient were 1824.62€ (with a median of 827.5€) 25 and 27 percentiles of 264.1€ and 1824.7€, respectively. The bivariate analysis showed a significant correlation between these expenses and all the demographic variables; the expenses increased when a nursing diagnosis has been made (Spearman's rank=0.37: the more diagnoses, the more expenses). In the multivariate analysis, a first linear regression with the sociodemographic variables as independent variables explains 13.7% of the variability of the logarithm of the full costs (R=0.137). If we add to this model the presence of nursing diagnoses, the explanatory capacity reaches 19.77% (R=0.1977).
Compared with a model that only consists of sociodemographic variables, nursing diagnoses can enhance the explanatory capacity of the use of healthcare resources.
医疗卫生服务将高达75%的资源投入到慢性病护理中，而慢性病护理的重点应是关怀而非治愈。护理人员将工作重点放在此类护理上。护理需要通过标准化语言记录在健康史中。这些记录有助于对组织和医疗决策进行有益分析。我们的提议是了解护理诊断与更高的医疗总支出之间的关联。
基于2012 - 2013年加那利群岛50岁以上患者的初级保健电子健康记录（Drago - AP）、医院出院记录（CMBD - AH）和处方记录（REC - SCS）数据进行了一项观察性横断面分析研究。进行了描述性、双变量和多变量分析以建立资源使用的预测模型。
2012年末记录的社会人口统计学变量（年龄、性别、医疗保健隶属类型、处方收费类型）和护理诊断（ND）。因变量：2013年消耗的资源。
582,171名患者符合纳入标准。其中53.0%为女性，平均年龄64.3岁（标准差10.8岁）。53.2%为退休人员。纳入人群中有49%有护理诊断，每位患者平均有2.1个护理诊断。每位患者的平均费用为1824.62€（中位数为827.5€），第25和第27百分位数分别为264.1€和1824.7€。双变量分析显示这些费用与所有人口统计学变量之间存在显著相关性；做出护理诊断时费用增加（斯皮尔曼等级相关系数 = 0.37：诊断越多，费用越高）。在多变量分析中，以社会人口统计学变量为自变量的第一个线性回归解释了全部费用对数变异性的13.7%（R = 0.137）。如果在此模型中加入护理诊断的存在情况，解释能力达到19.77%（R = 0.1977）。
与仅由社会人口统计学变量组成的模型相比，护理诊断可以提高医疗资源使用情况的解释能力。
