Kulkarni Kunal, Shepherd Sophie
Department of Trauma and Orthopaedics, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW.
Department of Surgery, East and North Herts NHS Trust, Stevenage, UK.
Int J Health Plann Manage. 2019 Jan;34(1):71-86. doi: 10.1002/hpm.2571. Epub 2018 Jul 27.
The increasingly complex care needs of an expanding and ageing population leave a growing dichotomy between demand and supply. With sustainable cost-efficiency gains paramount, this study explored awareness of trauma and orthopaedic (T&O) care costs among patients and health care providers, alongside the impact of greater cost awareness on care quality, experience, and equality.
Surveys were distributed over a 2-week period, at a single site, to in/outpatients and health care professionals allied to T&O. They evaluated (1) awareness of the costs of several common aspects of T&O care and (2) opinions on improved cost education.
Most professionals and patients had limited and markedly variable awareness of costs. Expensive items (>£200) were commonly underestimated, and cheap items (≤£200) were overestimated. The majority reported greater cost awareness might influence their approach to care decisions.
Cost ignorance restricts cost-efficiency and provision of equitable care. Given the widespread lack of cost education, there is unsurprisingly a lack of cost awareness among patients and professionals alike. Cost savings through "reduced waste" were a commonly highlighted potential benefit of greater cost awareness. Patients and professionals alike must become increasingly accountable for ensuring effective and efficient use of resources.
不断增长且老龄化的人口对医疗护理的需求日益复杂,导致供需之间的差距越来越大。鉴于可持续成本效益的提升至关重要,本研究探讨了患者和医疗服务提供者对创伤与骨科(T&O)护理成本的认知,以及更高的成本意识对护理质量、体验和平等性的影响。
在两周时间内,于单一地点向T&O相关的门诊/住院患者及医疗专业人员发放调查问卷。问卷评估了(1)对T&O护理几个常见方面成本的认知,以及(2)对改进成本教育的看法。
大多数专业人员和患者对成本的认知有限且差异显著。昂贵项目(>200英镑)常被低估,而便宜项目(≤200英镑)则被高估。大多数人表示更高的成本意识可能会影响他们在护理决策上的做法。
对成本的忽视限制了成本效益和公平护理的提供。鉴于普遍缺乏成本教育,患者和专业人员缺乏成本意识也就不足为奇了。通过“减少浪费”实现成本节约是更高成本意识通常会凸显的潜在益处。患者和专业人员都必须对确保有效且高效地利用资源承担起越来越多的责任。