Nova School of Business and Economics, Carcavelos, Portugal.
Lancaster University, Lancaster, UK.
BMC Pediatr. 2023 Aug 31;23(1):436. doi: 10.1186/s12887-023-04268-8.
Unplanned critical care admissions following in-hospital deterioration in children are expected to impose a significant burden for carers across a number of dimensions. One dimension relates to the financial and economic impact associated with the admission, from both direct out-of-pocket expenditures, as well as indirect costs, reflecting productivity losses. A robust assessment of these costs is key to understand the wider impact of interventions aiming to reduce in-patient deterioration. This work aims to determine the economic burden imposed on carers caring for hospitalised children that experience critical deterioration events.
Descriptive study with quantitative approach. Carers responded to an online survey between July 2020 and April 2021. The survey was developed by the research team and piloted before use. The sample comprised 71 carers of children admitted to a critical care unit following in-patient deterioration, at a tertiary children's hospital in the UK. The survey provides a characterisation of the carer's household and estimates of direct non-medical costs grouped in five different expenditure categories. Productivity losses can also be estimated based on the reported information.
Most carers reported expenditures associated to the child's admission in the week preceding the survey completion. Two-thirds of working carers had missed at least one workday in the week prior to the survey completion. Moreover, eight in ten carers reported having had to travel from home to the hospital at least once a week. These expenditures, on average, amount to £164 per week, grouped in five categories (38% each to travelling costs and to food and drink costs, with accommodation, childcare, and parking representing 12%, 7% and 5%, respectively). Additionally, weekly productivity losses for working carers are estimated at £195.
Unplanned critical care admissions for children impose a substantial financial burden for carers. Moreover, productivity losses imply a subsequent cost to society. Even though subsidised hospital parking and on-site accommodation at the hospital contribute to minimising such expenditure, the overall impact for carers remains high. Interventions aiming at reducing emergency critical care admissions, or their length, can be crucial to further contribute to the reduction of this burden.
Current Controlled Trials ISRCTN61279068, date of registration 07/06/2019, retrospectively registered.
在医院内病情恶化后，计划外的儿童重症监护病房入院预计将给护理人员带来多方面的巨大负担。其中一个方面与入院相关的财务和经济影响有关，包括直接自付支出以及反映生产力损失的间接成本。对这些成本进行全面评估是了解旨在减少住院恶化的干预措施的更广泛影响的关键。这项工作旨在确定经历危急恶化事件的住院儿童的护理人员所承担的经济负担。
描述性研究，采用定量方法。护理人员于 2020 年 7 月至 2021 年 4 月期间在线回答了一份调查问卷。该调查问卷由研究团队开发，并在使用前进行了试点。样本包括英国一家三级儿童医院的重症监护病房因住院恶化而入院的 71 名儿童的护理人员。该调查提供了护理人员家庭的特征描述，并按五个不同支出类别估算了直接非医疗费用。根据报告的信息，还可以估算生产力损失。
大多数护理人员报告了在调查完成前一周与孩子入院相关的支出。三分之二的在职护理人员在调查完成前一周至少请了一天假。此外，十分之八的护理人员报告说，他们每周至少要从家到医院一次。这些支出平均每周 164 英镑，分为五类（旅行费用占 38%，食品和饮料费用占 38%，住宿、儿童保育和停车分别占 12%、7%和 5%）。此外，在职护理人员每周的生产力损失估计为 195 英镑。
儿童计划外的重症监护病房入院给护理人员带来了巨大的经济负担。此外，生产力损失意味着对社会造成了后续成本。尽管医院提供补贴的停车和医院内的住宿有助于减少此类支出，但护理人员的整体负担仍然很高。旨在减少紧急重症监护病房入院或其住院时间的干预措施可能对进一步减轻这一负担至关重要。
当前对照试验 ISRCTN61279068，注册日期 2019 年 6 月 7 日，回顾性注册。
