Caterinicchio R P, Davies R H
Soc Sci Med. 1983;17(5):259-72. doi: 10.1016/0277-9536(83)90328-3.
A sample survey (N = 2660) was conducted at eight acute care hospitals in New Jersey during an 11-month period between 1979 and 1981 in order to develop a client-focused, case-mix sensitive measure of resource use for the allocation of inpatient general nursing costs. Using general linear modelling techniques, the direct and indirect effects of age, length of stay, multiple diagnoses, multiple procedures, the ratio of special care unit days to length of stay and the effects of the presence of surgery, admission status, discharge status and membership in Major Diagnostic Categories on indexed total units of nursing service were explored. The results of the analysis suggested that length of stay is the most significant predictor of indexed nursing units of service regardless of age and the complexity of the medical problem when case-mix is controlled through the assignment of cases to 13 nursing services isoresource clusters. The methodology yields an empirically derived patient-specific, case-mix adjusted length of stay statistic which can be used to apportion nursing costs by the case. The approach permits the estimation of nursing units of service which reflect the relative amount of nursing inputs and corresponding costs of direct patient care consumed by any given inpatient in any given hospital.
1979年至1981年期间，在11个月内对新泽西州的八家急症护理医院进行了一项抽样调查（N = 2660），目的是制定一种以客户为中心、对病例组合敏感的资源使用衡量方法，用于分配住院普通护理费用。运用一般线性建模技术，探讨了年龄、住院时间、多种诊断、多种手术、特殊护理单元天数与住院时间的比率，以及手术的存在、入院状态、出院状态和主要诊断类别成员资格对护理服务索引总单位的直接和间接影响。分析结果表明，在通过将病例分配到13个护理服务等资源集群来控制病例组合的情况下，无论年龄和医疗问题的复杂性如何，住院时间都是护理服务索引单位最显著的预测因素。该方法得出了一个基于经验的针对特定患者、经病例组合调整的住院时间统计数据，可用于按病例分摊护理费用。该方法允许估算护理服务单位，这些单位反映了任何给定医院中任何给定住院患者所消耗的护理投入相对量和直接患者护理的相应成本。
