Health care and social welfare costs in home-based and hospital-based rehabilitation after stroke.
Health care and social welfare costs in home-based and hospital-based rehabilitation after stroke.
复制标题
中风后家庭和医院康复的医疗保健和社会福利费用。
DOI：
10.1046/j.1471-6712.2002.00115.x
复制
发表时间：
2002
影响因子：
1.9
通讯作者：
Linda Mansson
中科院分区：
文献类型：
--
作者：
A. Andersson;L. Levin;B. Oberg;Linda Mansson
20世纪90年代，大多数西欧国家和经济合作与发展组织（经合发组织）国家经历了财政困难，被迫削减或限制保健支出。近年来，由于有可能控制费用，家庭康复受到了重视。然而，经常被遗忘的是，从一个照顾者到另一个照顾者的成本再分配。这项研究的目的是分析在中风后以家庭为基础的康复和以医院为基础的康复的比较中，医疗保健提供者（县议会）和社会福利提供者（市）之间是否发生了成本再分配。研究人群包括123名患者，其中53名在家庭康复组，68名在医院康复组。随访时间分别为中风发作后6个月和12个月。12个月期间的资源使用包括急性病住院治疗、住院康复、家庭康复和使用家政服务以及养老院生活。在紧急护理病房作出康复决定后，以医院为基础的康复组的住院天数显著减少，因此，紧急护理期的费用显著降低。在以家庭为基础的康复组中，康复期的费用明显较低。然而，在以家庭为基础的康复组中，家庭帮助服务的成本明显更高。两组之间的护理总费用没有差异。本研究的主要发现是，在一组有不同程度损伤的患者中风后的家庭康复中，医疗保健提供者和社会福利提供者之间似乎出现了成本的再分配。
During the 1990s most western European and Organization of Economic Cooperation and Development (OECD) countries experienced financial difficulties and were forced to cut back on or restrain health care expenditures. Home rehabilitation has received attention in recent years because of its potential for cost containment. Often forgotten, however, is the redistribution of costs from one caregiver to another. The aim of this study was to analyse whether a redistribution of costs occurs between health care providers (the County councils) and social welfare providers (the municipalities) in a comparison of home-based rehabilitation and hospital-based rehabilitation after stroke. The study population included 123 patients, 53 in the home-based rehabilitation group and 68 in the hospital-based rehabilitation group. The patients were followed up at 6 and 12 months after onset of stroke. Resource use over a 12-month period included acute hospital care, in-hospital rehabilitation, home rehabilitation and use of home-help service as well as nursing home living. The hospital-based rehabilitation group had significantly fewer hospitalization days after a decision was made about rehabilitation at the acute care ward and consequently the cost for the acute care period was significantly lower. The cost for the rehabilitation period was significantly lower in the home-based rehabilitation group. However, the cost for home help service was significantly higher in the home-based rehabilitation group. The total costs for the care episode did not differ between the two groups. The main finding of this study is that there seems to occur a redistribution of costs between health care providers and social welfare providers in home rehabilitation after stroke in a group of patients with mixed degree of impairment.