临终关怀中的成本节约：国家临终关怀研究的最终结果
Cost savings in hospice: final results of the National Hospice Study.
作者信息
Mor V, Kidder D
出版信息
Health Serv Res. 1985 Oct;20(4):407-22.
Medicare inpatient and home care costs over the last year of life of terminal cancer patients served in two types of hospices and in conventional care (CC) were compared as a part of the National Hospice Study (NHS). Both home care (HC) and hospital-based (HB) hospice patients had lower costs in the last month of life than did CC patients. HC patients substituted home care for inpatient care, yielding cost savings for lengths of hospice stay of up to 1 year. Although HB patients added home care to relatively high levels of inpatient care, their ancillary costs per inpatient day were significantly lower than those of CC patients. Thus, HB costs over the last year of life were also somewhat less than those of CC. The size of the savings associated with hospice care is sensitive to the type of hospice and the length of stay distribution of patients served; patients served longer have significantly higher costs in the last year of life.
作为国家临终关怀研究（NHS）的一部分，对在两类临终关怀机构和常规护理（CC）中接受服务的晚期癌症患者生命最后一年的医疗保险住院和家庭护理费用进行了比较。家庭护理（HC）患者和医院型（HB）临终关怀患者在生命的最后一个月的费用均低于CC患者。HC患者用家庭护理替代了住院护理，在长达1年的临终关怀住院时间内节省了费用。尽管HB患者在相对较高水平的住院护理基础上增加了家庭护理，但他们每天住院的辅助费用明显低于CC患者。因此，HB患者生命最后一年的费用也略低于CC患者。与临终关怀护理相关的节省规模对临终关怀机构的类型以及所服务患者的住院时间分布敏感；住院时间较长的患者在生命的最后一年费用显著更高。
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