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德国新生儿重症监护病房中医生和护士的成本意识差异。

Differences in cost consciousness between physicians and nurses in German neonatal intensive care units.

机构信息

Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), University Hospital of Cologne, University of Cologne, Cologne, Germany.

Children's and Adolescents' Hospital, University Hospital of Cologne, Cologne, Germany.

出版信息

Acta Paediatr. 2019 Feb;108(2):245-252. doi: 10.1111/apa.14479. Epub 2018 Jul 26.

Abstract

AIM

This study assessed the cost consciousness of nurses and physicians in German neonatal intensive care units (NICUs) and identified factors affecting cost consciousness.

METHODS

This study on cost consciousness was part of the German Safety4NICU study, a cross-sectional survey conducted from 2015 to 2016. All 224 German NICUs were invited to take part in the survey, and written consent was obtained from the leading physicians and nurses. The various professions were addressed via specific questionnaires. The cost survey tool identified the participants' responsibility and their desired focus on cost consciousness.

RESULTS

Of the 1406 nurses and 496 physicians from 84 NICUs, 64.4% of the nurses and 62.5% of the physicians agreed that they shared responsibility for controlling costs. The computed score to define the overall cost consciousness level was 4.47. We identified a significantly positive association between cost consciousness, longer total clinical work experience and a decreased number of NICU intensive care beds. Increased cost consciousness was found in both men and physicians. Other hospital characteristics did not have an effect.

CONCLUSION

Neonatology is a medical speciality where the tension between economics and the benefit of patients is extremely high. We found a moderate level of cost consciousness among NICU physicians and nurses.

摘要

目的

本研究评估了德国新生儿重症监护病房(NICU)护士和医生的成本意识,并确定了影响成本意识的因素。

方法

本项关于成本意识的研究是德国 Safety4NICU 研究的一部分,该研究是一项横断面调查,于 2015 年至 2016 年进行。邀请了所有 224 家德国 NICU 参与调查,并获得了主治医生和护士的书面同意。通过特定的问卷向各个专业人员提出了问题。成本调查工具确定了参与者的责任及其对成本意识的期望重点。

结果

在来自 84 家 NICU 的 1406 名护士和 496 名医生中,64.4%的护士和 62.5%的医生同意他们共同负责控制成本。定义整体成本意识水平的计算得分是 4.47。我们发现成本意识与更长的总临床工作经验和更少的 NICU 重症监护床位之间存在显著正相关。在男性和医生中都发现了更高的成本意识。其他医院特征没有影响。

结论

新生儿学是一个医学专业,其经济效益和患者利益之间的紧张关系极高。我们发现 NICU 医生和护士的成本意识处于中等水平。

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