Bergner M, Hudson L D, Conrad D A, Patmont C M, McDonald G J, Perrin E B, Gilson B S
Department of Health Services, University of Washington, Seattle.
Med Care. 1988 Jun;26(6):566-79. doi: 10.1097/00005650-198806000-00005.
A randomized controlled trial was conducted to assess efficacy and cost of sustained home nursing care for patients with chronic lung disease. Three hundred one patients were randomly assigned to a respiratory home care group (RHC) that received care from respiratory home care nurses, a standard home care group (SHC) that received care from regular home care nurses, or an office care group (OC) that received whatever care they needed except for home care. Patients were followed for 1 year. At the end of the study year, there was no difference in survival, pulmonary function, or everyday functioning among the three groups. Average annual cost of care for all study patients was $7,647 (1981-82 dollars). The average annual health care costs for patients in the RHC group was $9,768; for those in the SHC group, $8,058; and for those in the OC group, $5,051 (F = 6.45, df = 2/298, P = 0.02). These results suggest that the current policy of limited coverage of home nursing services by Medicare and other third-party payers may be appropriate.
开展了一项随机对照试验，以评估对慢性肺病患者持续进行家庭护理的疗效和成本。301名患者被随机分配到呼吸家庭护理组（RHC），该组由呼吸家庭护理护士提供护理；标准家庭护理组（SHC），由常规家庭护理护士提供护理；或办公室护理组（OC），该组接受除家庭护理外他们所需的任何护理。对患者进行了1年的随访。在研究年度结束时，三组在生存率、肺功能或日常功能方面没有差异。所有研究患者的年均护理成本为7647美元（1981 - 1982年美元）。RHC组患者的年均医疗保健成本为9768美元；SHC组为8058美元；OC组为5051美元（F = 6.45，自由度 = 2/298，P = 0.02）。这些结果表明，医疗保险和其他第三方支付者目前对家庭护理服务覆盖范围有限的政策可能是合适的。
