Schnelle J F, Sowell V A, Hu T W, Traughber B
Middle Tennessee State University, Psychology Department, Murfreesboro 37132.
J Am Geriatr Soc. 1988 Jan;36(1):34-9. doi: 10.1111/j.1532-5415.1988.tb03431.x.
Labor and supply costs associated with the care of urinary incontinent patients in three nursing homes were measured. First, normal nursing home changing patterns and their associated costs were measured. Second, the costs were documented when patients were checked by research staff and changed on an hourly basis as needed. Nursing home staff changed patients significantly less frequently than patient voiding as detected by the hourly checking system. Thus, cost of incontinence during the hourly checking condition ($3.35) per 12-hour patient-day was significantly higher than the cost normally incurred in nursing homes ($1.52) per 12-hour patient-day. The cost of an incontinence rehabilitation program, which significantly reduced incontinence episodes, was contrasted to the cost of incontinence as measured under both of the previous conditions. The rehabilitation program produced significant labor and supply savings only when compared with the hourly checking and changing system. Maintaining patients in a more continent condition costs significantly more than the direct incontinence cost normally incurred by the nursing home. Quality of life and other second-order benefits must be considered if continence rehabilitation is to be judged cost-effective.
对三家养老院中与尿失禁患者护理相关的劳动力和供应成本进行了测算。首先，测量了养老院正常的更换模式及其相关成本。其次，记录了研究人员进行检查并根据需要每小时更换患者时的成本。每小时检查系统检测发现，养老院工作人员更换患者的频率明显低于患者排尿频率。因此，每12小时患者日的每小时检查情况下的尿失禁成本（3.35美元）显著高于养老院正常产生的每12小时患者日成本（1.52美元）。将显著减少尿失禁发作次数的尿失禁康复计划的成本与在前述两种情况下测得的尿失禁成本进行了对比。仅与每小时检查和更换系统相比时，康复计划才产生了显著的劳动力和供应成本节省。使患者保持更高的控尿状态的成本明显高于养老院通常产生的直接尿失禁成本。如果要判断尿失禁康复是否具有成本效益，则必须考虑生活质量和其他次要益处。
