Xakellis G C, Frantz R, Lewis A
John Deere Health Care, Moline, Illinois 61265, USA.
J Am Geriatr Soc. 1995 May;43(5):496-501. doi: 10.1111/j.1532-5415.1995.tb06095.x.
To describe the total cost of pressure ulcer prevention, component costs of each intervention, and the relationship of costs to subjects' risk level.
3-month cohort trial.
A 600-bed, state-supported, long-term care facility.
A total of 539 war veterans, 83% of whom were male; mean age was 73 years.
Cost to facility for using each of four preventive interventions: turning, pressure-reducing mattresses, chair cushions, miscellaneous preventive devices.
Sixty-eight percent of subjects received a preventive intervention. Total 3-month facility cost of prevention was $132,114, and 97% of the cost was consumed by 30% of the subjects. Turning was the most expensive component, accounting for $99,567. The daily cost of turning for subjects who received it was $8.83 +/- 1.66. Cost increased with subject risk level. Low cost devices were instituted for lower risk subjects, whereas high cost interventions (turning) were reserved for the highest risk subjects.
This long-term care facility expended substantial resources on prevention, and most resources (97%) were expended on less than half (30%) of subjects. Turning was, by far, the most expensive intervention, and the nursing staff reserved it for highest risk subjects. Strategies that substitute moderately priced mattresses for frequent turning may decrease the cost of prevention, as long as mattress cost is less than the daily turning costs it replaces. Future research to define the optimum combinations of preventive interventions for patients of various risk levels is needed.
描述压疮预防的总成本、每种干预措施的组成成本以及成本与受试者风险水平的关系。
为期3个月的队列试验。
一家拥有600张床位、由州政府资助的长期护理机构。
共有539名退伍军人，其中83%为男性；平均年龄为73岁。
使用四种预防干预措施（翻身、减压床垫、椅垫、其他预防设备）对机构造成的成本。
68%的受试者接受了预防干预。3个月的预防总费用为132,114美元，其中97%的费用由30%的受试者产生。翻身是最昂贵的组成部分，占99,567美元。接受翻身干预的受试者每天的费用为8.83±1.66美元。成本随受试者风险水平增加。低风险受试者采用低成本设备，而高成本干预措施（翻身）则用于风险最高的受试者。
这家长期护理机构在预防方面投入了大量资源，且大部分资源（97%）用于不到一半（30%）的受试者身上。到目前为止，翻身是最昂贵的干预措施，护理人员将其用于风险最高的受试者。只要床垫成本低于其所替代的每日翻身成本，用价格适中的床垫替代频繁翻身的策略可能会降低预防成本。未来需要开展研究来确定针对不同风险水平患者的最佳预防干预措施组合。
