Department of Nursing and Medical Rescue, Pomeranian University, Słupsk, Poland.
Institute of Nursing and Midwifery, Medical University of Gdańsk, Gdańsk, Poland.
Front Public Health. 2024 Sep 16;12:1228471. doi: 10.3389/fpubh.2024.1228471. eCollection 2024.
Falls are associated with increased morbidity, mortality, prolonged hospitalization and an increase in the cost of treatment in hospitals. They contribute to the deterioration of fitness and quality of life, especially among older patients, thus posing a serious social and economic problem. They increase the risk of premature death. Falls are adverse, costly, and potentially preventable. The aim of the study was to analyze the cost-effectiveness of avoiding one fall by nurse care provided by the nurses with higher education, from the perspective of the health service provider.
The economic analysis included and compared only the cost of nurse intervention measured by the hours of care provided with higher education in non-surgical departments (40.5%) with higher time spend by nurses with higher education level an increase in the number of hours by 10% (50.5%) to avoid one fall. The time horizon for the study is 1 year (2021). Cost-effectiveness and Cost-benefit analysis were performed. All registered falls of all hospitalized patients were included in the study.
In the analyzed was based on the case control study where, 7,305 patients were hospitalized, which amounted to 41,762 patient care days. Care was provided by 100 nurses, including 40 nurses with bachelor's degrees and nurses with Master of Science in Nursing. Increasing the hours number of high-educated nurses care by 10% in non-surgical departments decreased the chance for falls by 9%; however, this dependence was statistically insignificant (OR = 1.09; 95% CI: 0.72-1.65; = 0.65). After the intervention (a 10% increase in Bachelor's Degrees/Master of Science in Nursing hours), the number of additional Bachelor's Degrees/Master of Science hours was 6100.5, and the cost was USD 7630.4. The intervention eliminated four falls. The cost of preventing one fall is CER = USD 1697.1.
The results of these studies broaden the understanding of the relationship among nursing education, falls, and the economic outcomes of hospital care. According to the authors, the proposed intervention has an economic justification.
跌倒与发病率、死亡率增加、住院时间延长以及医院治疗费用增加有关。它们会导致身体状况和生活质量恶化，尤其是在老年患者中，因此构成了一个严重的社会和经济问题。它们增加了过早死亡的风险。跌倒具有不良影响、代价高昂且潜在可预防。本研究的目的是从医疗服务提供者的角度分析通过高等教育护士提供的护理来避免一次跌倒的成本效益。
经济分析仅包括并比较了通过非手术科室提供的高等教育护理小时数（40.5%）测量的护士干预成本，以及通过增加 10%（50.5%）的高等教育护士时间数来避免一次跌倒所需的护理小时数。研究的时间范围为 1 年（2021 年）。进行了成本效益和成本效益分析。所有住院患者的所有登记跌倒均纳入研究。
在基于病例对照研究的分析中，有 7305 名患者住院，共计 41762 名患者护理日。护理由 100 名护士提供，其中包括 40 名拥有学士学位的护士和拥有护理学硕士学位的护士。在非手术科室增加高等教育护士护理时间数 10%可使跌倒的机会降低 9%；然而，这种依赖性在统计学上无显著性（OR=1.09；95%CI：0.72-1.65；p=0.65）。干预（护理学士学位/护理学硕士学位小时数增加 10%）后，额外的学士学位/护理学硕士学位小时数为 6100.5，成本为 7630.4 美元。干预消除了 4 起跌倒。预防一次跌倒的成本为 CER=1697.1 美元。
这些研究的结果拓宽了对护理教育、跌倒以及医院护理经济结果之间关系的理解。根据作者的说法，拟议的干预措施具有经济合理性。
