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低气耗床治疗压疮的成本效益

Cost-effectiveness of low-air-loss beds for treatment of pressure ulcers.

作者信息

Ferrell B A, Keeler E, Siu A L, Ahn S H, Osterweil D

机构信息

UCLA School of Medicine, USA.

出版信息

J Gerontol A Biol Sci Med Sci. 1995 May;50(3):M141-6. doi: 10.1093/gerona/50a.3.m141.

DOI:10.1093/gerona/50a.3.m141
PMID:7743399
Abstract

BACKGROUND

Cost-effectiveness of low-air-loss beds for the healing of pressure ulcers was analyzed in the nursing home setting. A statistical model of pressure ulcer healing was used to estimate cost-effectiveness based on patient and ulcer characteristics.

METHODS

Results of a previous randomized trial (84 patients from three nursing homes in Los Angeles) were reanalyzed and combined with estimates of costs to calculate the cost-effectiveness in dollars per added day free of pressure ulcers achieved by the use of low-air-loss beds compared to conventional foam mattresses.

RESULTS

The cost-effectiveness of the low-air-loss bed was $26 per added day free of ulcers for our standard patient. Results were sensitive to low-air-loss bed lease costs and patient and wound healing characteristics. Results were less sensitive to expected mortality, daily wound care costs, and time-frame of consideration. Low-air-loss beds were more cost-effective for patients with good healing characteristics and mild ulcers.

CONCLUSIONS

Findings support the expanded use of this technology for patients with mild pressure ulcers and good healing characteristics. For these patients, the cost-effectiveness of low-air-loss beds is comparable to other accepted health treatments. For patients with severe ulcers and poor healing characteristics, low-air-loss bed cost-effectiveness compares poorly with other accepted health treatments unless the lease cost can be substantially reduced, or unless life with a pressure ulcer is valued close to death.

摘要

背景

在疗养院环境中分析了低气耗床对压疮愈合的成本效益。基于患者和溃疡特征,使用压疮愈合的统计模型来估计成本效益。

方法

对先前一项随机试验(来自洛杉矶三家疗养院的84名患者)的结果进行重新分析,并结合成本估计,以计算与传统泡沫床垫相比,使用低气耗床每增加一天无压疮天数所实现的成本效益(以美元计)。

结果

对于我们的标准患者,低气耗床的成本效益为每增加一天无溃疡26美元。结果对低气耗床租赁成本以及患者和伤口愈合特征敏感。结果对预期死亡率、每日伤口护理成本和考虑的时间范围不太敏感。低气耗床对于愈合特征良好和轻度溃疡的患者更具成本效益。

结论

研究结果支持将该技术扩大应用于轻度压疮且愈合特征良好的患者。对于这些患者,低气耗床的成本效益与其他公认的健康治疗相当。对于严重溃疡且愈合特征差的患者,低气耗床的成本效益与其他公认的健康治疗相比不佳,除非租赁成本能够大幅降低,或者除非对带压疮生活的估值接近死亡。

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