Feeley R, Walsh D C, Fielding J E
Am J Law Med. 1977;3(4):447-54.
The authors of this Comment note recent trends rigidifying the enforcement of building and safety codes for health care facilities and compare the estimated costs (in terms of dollars spent) of those trends with their anticipated benefits (in terms of potential years of human life saved). They estimate that for each potential year of life saved, strict enforcement of the Life Safety Code of the National Fire Protection Association would cost $12.7 to $63.5 million for hospitals and $1.1 to $2.6 million for nursing homes, the latter figure based on Massachusett's experience. These figures are contrasted to the cost of routine kidney dialysis, which is generally acknowledged to be an extremely expensive technology, costing approximately $20,000 per potential year of life saved. The authors suggest that even if strict enforcement of the Code were fully effective (which, given the current structure of the Code, seems doubtful), a portion of the substantial financial resources expended from our limited national health care budget in hewing to the letter of the Code might be better spent on other activities with greater potential yield in improving the quality of life for patients in hospitals and nursing homes.
本评论文章的作者注意到近期在强化医疗保健设施建筑与安全法规执行方面的趋势，并将这些趋势的估计成本（以花费的美元计）与其预期效益（以潜在挽救的人类生命年数计）进行了比较。他们估计，为了每一个潜在挽救的生命年，严格执行美国国家消防协会的《生命安全规范》，医院将花费1270万至6350万美元，疗养院将花费110万至260万美元（后者是根据马萨诸塞州的经验得出）。这些数字与常规肾脏透析的成本形成对比，肾脏透析通常被认为是一项极其昂贵的技术，每挽救一个潜在生命年的成本约为2万美元。作者认为，即使严格执行该规范完全有效（鉴于该规范目前的结构，这似乎令人怀疑），从我们有限的国家医疗保健预算中支出的大量财政资源，在严格遵守该规范方面，一部分可能更好地用于其他活动，这些活动在改善医院和疗养院患者生活质量方面具有更大的潜在收益。
