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社区中慢性伤口患者的经济和生活质量成本。

The financial and quality-of-life cost to patients living with a chronic wound in the community.

机构信息

Department of Nursing, School of Health Sciences, University of Melbourne, Melbourne, VIC, Australia.

出版信息

Int Wound J. 2017 Dec;14(6):1108-1119. doi: 10.1111/iwj.12767. Epub 2017 Jun 20.

Abstract

Chronic wounds are associated with financial and personal costs. The system level expense associated with chronic wounds has been established, however, the out-of-pocket cost incurred by individuals who self-fund has not been the focus of extensive investigation. Recently, there has been renewed interest in evaluating quality of life, in line with the shift to patient enablement and self-care in chronic disease management. The objectives of this research were to describe the out-of-pocket wound treatment costs and the quality of life of people who have chronic wounds. A questionnaire incorporating the Cardiff Wound Impact Schedule and purpose-designed instruments was completed by a non-probability, convenience sample of 113 people in Australia and Wales. Data was analysed using descriptive statistics. The sample was on average 63·6 years of age and had wounds that were on an average 109 weeks duration. Participants had spent on average AU$2475 on wound dressing products since the wound started, and AU$121·82 in the most recent 28 days which represented 10% of their disposable income. Health-related quality of life was sub-optimal, 6/10 (ave) according to the Cardiff Wound Impact Schedule. Younger participants reported significantly poorer quality of life on all CWIS sub-scales when compared to older participants. This study found that chronic wounds present a significant financial cost to individuals who must self-fund their wound dressings and other wound treatment related expenses. Participants who had access to wound product subsidisation also experienced personal financial costs. People who have chronic wounds experience sub-optimal quality of life therefore this condition is also costly to the individual's well-being. The quality of life of younger people has not received adequate attention and requires further consideration given the many years that younger people may have to live with this debilitating and often recurrent condition. Continued action is required to reduce the financial and personal costs experienced by people who have chronic wounds. It is imperative that healthcare funding is directed to people who have chronic wounds, in particular to alleviate the out-of-pocket costs experienced by self-funders. Continued attention to the quality of life of people who have chronic wounds is required to minimise the negative effects of this condition and enhance well-being.

摘要

慢性伤口会带来经济和个人负担。虽然已经确定了与慢性伤口相关的系统层面的费用,但个人自费承担的费用并未成为广泛调查的重点。最近,人们对生活质量的评估重新产生了兴趣,这与慢性病管理中向患者赋权和自我护理的转变是一致的。本研究的目的是描述慢性伤口患者的自付伤口治疗费用和生活质量。我们采用问卷调查的方式,对澳大利亚和威尔士的 113 名非概率便利样本进行了评估,问卷中包含了卡迪夫伤口影响量表(Cardiff Wound Impact Schedule)和专门设计的工具。使用描述性统计方法对数据进行了分析。该样本的平均年龄为 63.6 岁,伤口平均持续 109 周。自伤口开始以来,参与者平均在伤口敷料产品上花费了 2475 澳元,在最近的 28 天内花费了 121.82 澳元,占其可支配收入的 10%。根据卡迪夫伤口影响量表,健康相关生活质量较差,平均得分为 6/10。与老年参与者相比,年轻参与者在所有 CWIS 子量表上的报告生活质量明显更差。本研究发现,对于那些必须自费购买伤口敷料和其他伤口治疗相关费用的人来说,慢性伤口会带来重大的经济负担。那些获得伤口产品补贴的人也会经历个人经济成本。患有慢性伤口的人生活质量较差,因此这种疾病也会给个人的幸福感带来成本。年轻人的生活质量尚未得到足够关注,鉴于年轻人可能需要多年时间才能摆脱这种使人衰弱且经常复发的疾病,因此需要进一步考虑。需要采取持续行动来减轻慢性伤口患者所经历的经济和个人负担。至关重要的是,医疗保健资金应投向慢性伤口患者,特别是要减轻自费患者的自付费用。需要持续关注慢性伤口患者的生活质量,以尽量减少这种疾病的负面影响,提高幸福感。

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