Rudy E B, Daly B J, Douglas S, Montenegro H D, Song R, Dyer M A
University of Pittsburgh, School of Nursing, PA, USA.
Nurs Res. 1995 Nov-Dec;44(6):324-31.
The purpose of this study was to compare the effects of a low-technology environment of care and a nurse case management case delivery system (special care unit, SCU) with the traditional high-technology environment (ICU) and primary nursing care delivery system on the patient outcomes of length of stay, mortality, readmission, complications, satisfaction, and cost. A sample of 220 chronically critically ill patients were randomly assigned to either the SCU (n = 145) or the ICU (n = 75). Few significant differences were found between the two groups in length of stay, mortality, or complications. However, the findings showed significant cost savings in the SCU group in the charges accrued during the study period and in the charges and costs to produce a survivor. The average total cost of delivering care was $5,000 less per patient in the SCU than in the traditional ICU. In addition, the cost to produce a survivor was $19,000 less in the SCU. Results from this 4-year clinical trial demonstrate that nurse case managers in a SCU setting can produce patient outcomes equal to or better than those in the traditional ICU care environment for long-term critically ill patients.
本研究的目的是比较低技术护理环境和护士个案管理病例提供系统（特殊护理单元，SCU）与传统高技术环境（ICU）及初级护理提供系统对患者住院时间、死亡率、再入院率、并发症、满意度和成本等结果的影响。220例慢性危重症患者样本被随机分配至SCU组（n = 145）或ICU组（n = 75）。两组在住院时间、死亡率或并发症方面几乎未发现显著差异。然而，研究结果显示，SCU组在研究期间产生的费用以及产生一名幸存者的费用方面均显著节省成本。SCU提供护理的平均总成本比传统ICU每位患者少5000美元。此外，SCU产生一名幸存者的成本少19000美元。这项为期4年的临床试验结果表明，对于长期危重症患者，SCU环境下的护士个案管理者能够产生等同于或优于传统ICU护理环境下的患者结果。
