Jacobs P, Hall E, Henderson I, Nichols D
Department of Public Health Sciences, University of Alberta, Edmonton.
Can J Public Health. 1995 May-Jun;86(3):200-5.
To develop a measure of an acute care "episode of care" that incorporates hospital and home care portions of care, and to measure the costs of such episodes.
Patient level data from a home care program and an acute care hospital were linked using patient health insurance identification numbers. The linked database contained information on inpatient case mix, home care patient classification (i.e., type of care) and cost data for both settings. Data by patient classification were analyzed.
Patterns of resource use were very different for medical and surgical cases, home care costs being 25% of a medical episode and only 5% of a surgical episode. For surgical cases, the marginal cost of an extra surgical day is about equal to the marginal cost of an extra short-term home care case (i.e., a one-day reduction in a surgical inpatient length of stay would cover the cost of a home care stay). Medical cases would require a three-day reduction in inpatient cost.
制定一种急性护理“护理事件”的衡量方法，该方法纳入护理的医院和家庭护理部分，并衡量此类事件的成本。
利用患者健康保险识别号码将家庭护理项目和急性护理医院的患者层面数据进行链接。链接后的数据库包含住院病例组合、家庭护理患者分类（即护理类型）以及两种环境下的成本数据信息。对按患者分类的数据进行了分析。
医疗和外科病例的资源使用模式差异很大，家庭护理成本在医疗事件中占25%，而在外科事件中仅占5%。对于外科病例，额外一个手术日的边际成本大约等于额外一个短期家庭护理病例的边际成本（即手术住院天数减少一天将覆盖家庭护理住院的成本）。医疗病例需要住院成本降低三天。
