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成本控制的经济模型:评估一家急症医院中免接触氧化锌的使用情况。

Economic Model for Cost Containment: Evaluating the Utilization of a Touch-free Zinc Oxide in an Acute Care Hospital.

作者信息

Tolentino Ana Clara, Dick Sonya

机构信息

Gerontology/wound and Ostomy, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, BRA.

Neuroscience, University of Kentucky College of Medicine, Bowling Green, USA.

出版信息

Cureus. 2019 Jun 20;11(6):e4957. doi: 10.7759/cureus.4957.

Abstract

Introduction Incontinence-associated dermatitis (IAD), the most common form of moisture-associated skin damage (MASD), puts patients at higher risk for ulceration. Treatment of MASD/IAD includes application of zinc oxide, typically applied using gloved hands directly to the area of concern. A computational model was utilized to examine a cost comparison of a touch-free zinc oxide treatment versus traditional zinc oxide for MASD/IAD. Methods A literature search was performed using PubMed, a nursing journal database (CINAHL), and MEDLINE for publications from January 1, 2010 through November 30, 2017. Data on prevalence of MASD/IAD, average length of stay, and time to heal were extracted and utilized in the computational model. Cost per patient stay and annual total hospital costs were calculated for three and four applications of zinc oxide per patient with an averaged prevalence rate of 25% for a hypothetical hospital. Results The computational model estimated a range of cost savings between $181.88 to $2,000.63 per patient stay, and $4,728.88 to $52,016.25 over a 12-month period compared to traditional zinc oxide application. Conclusions The computational model estimated a cost savings of up to $52,016.25 per year in a hypothetical 250-bed acute care hospital compared to traditional zinc oxide application. Future prospective studies examining clinical effectiveness and health economics of touch-free zinc oxide are necessary.

摘要

引言 失禁相关性皮炎(IAD)是与潮湿相关皮肤损伤(MASD)最常见的形式,会使患者发生溃疡的风险更高。MASD/IAD的治疗包括应用氧化锌,通常是戴手套直接将其涂抹在相关部位。利用一个计算模型来检验无接触式氧化锌治疗与传统氧化锌治疗MASD/IAD的成本比较。

方法 通过PubMed、护理期刊数据库(CINAHL)和MEDLINE进行文献检索,查找2010年1月1日至2017年11月30日期间发表的文献。提取关于MASD/IAD患病率、平均住院时间和愈合时间的数据,并用于计算模型。对于一家假设的医院,以25%的平均患病率计算每位患者使用三次和四次氧化锌的每次住院成本和年度总医院成本。

结果 计算模型估计,与传统氧化锌应用相比,每位患者每次住院成本节省范围在181.88美元至2000.63美元之间,12个月期间节省4728.88美元至52016.25美元。

结论 计算模型估计,与传统氧化锌应用相比,一家假设的拥有250张床位的急性护理医院每年成本节省高达52016.25美元。未来有必要进行前瞻性研究,以检验无接触式氧化锌的临床有效性和卫生经济学。

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本文引用的文献

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Incontinence-associated dermatitis in a long-term acute care facility.长期急性护理机构中的失禁相关性皮炎。
J Wound Ostomy Continence Nurs. 2012 May-Jun;39(3):318-27. doi: 10.1097/WON.0b013e3182486fd7.
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