家庭康复的成本效益：一项针对瑞典老年人的研究。
The cost-effectiveness of rehabilitation in the home: a study of Swedish elderly.
作者信息
Melin A L, Håkansson S, Bygren L O
机构信息
Department of Social Medicine, University of Umeå, Stockholm, Sweden.
出版信息
Am J Public Health. 1993 Mar;83(3):356-62. doi: 10.2105/ajph.83.3.356.
OBJECTIVES
To investigate whether care of elderly and disabled patients could be more cost-effective after a short-term hospital stay, we examined the impact of a primary home care intervention program on functional status, use and costs of care after 6 months.
METHODS
When clinically ready for discharge from the hospital, chronically ill patients with dependence in one to five functions in personal activities of daily living were randomized to physician-led primary home care with a 24-hour service, and the controls were offered ordinary care. Physical, cognitive, social, and medical functions were assessed in 110 team subjects and 73 controls. Data regarding inpatient days and outpatient visits were collected and converted to costs.
RESULTS
Team patients demonstrated better instrumental activities of daily living and outdoor walking and significantly fewer diagnoses and drugs at 6 months. They used less inpatient and more outpatient care compared with the control patients. Significant cost reductions were found in the team group.
CONCLUSIONS
This primary home care intervention program is cost-effective, at least for a selection of patients at risk for long-term hospital care.
目的
为了调查在短期住院后，对老年及残疾患者的护理是否能更具成本效益，我们研究了一项初级家庭护理干预项目在6个月后对功能状态、护理利用情况及成本的影响。
方法
当慢性病患者在临床上已准备好出院，且在日常生活个人活动中有一至五项功能依赖时，将其随机分为接受由医生主导的24小时服务的初级家庭护理组，对照组则接受常规护理。对110名干预组受试者和73名对照组患者的身体、认知、社会及医疗功能进行了评估。收集了住院天数和门诊就诊的数据并换算为成本。
结果
干预组患者在6个月时展现出更好的日常生活工具性活动能力和户外行走能力，诊断和用药显著减少。与对照组患者相比，他们住院护理使用较少，门诊护理使用较多。干预组有显著的成本降低。
结论
这项初级家庭护理干预项目具有成本效益，至少对于一部分有长期住院护理风险的患者是如此。
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