Cohort study evaluating the burden of wounds to the UK’s National Health Service in 2017/2018: update from 2012/2013
Cohort study evaluating the burden of wounds to the UK’s National Health Service in 2017/2018: update from 2012/2013
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队列研究评估2017/2018年英国国家卫生服务的伤口负担：2012/2013年更新
DOI：
10.1136/bmjopen-2020-045253
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发表时间：
2020-12-22
期刊：
影响因子：
2.9
通讯作者：
Vowden P
中科院分区：
文献类型：
--
作者：
Guest JF;Fuller GW;Vowden P
评估2017/2018年英国国家卫生服务（NHS）管理的伤口的患病率以及相关的健康结局、资源使用和成本。对健康改善网络（THIN）数据库中患者电子记录的回顾性队列分析。英国的初级和二级保健部门。从THIN数据库中随机选择2017/2018年有伤口的3000例患者队列。患者特征、伤口相关健康结局、医疗资源使用和患者管理的NHS总成本。据估计，2017/2018年有380万患者的伤口由NHS管理，其中70%在研究年愈合; 89%和49%的急性和慢性伤口分别愈合。如果没有感染的证据，估计59%的慢性伤口愈合，而如果有明确或疑似感染，则为45%。急性伤口的愈合率不受感染的影响。吸烟状态似乎只影响慢性伤口的愈合率。归因于伤口管理的年度资源使用水平包括5440万次地区/社区护士访问，5360万次医疗保健助理访问和2810万次实习护士访问。NHS每年用于伤口管理的费用为83亿英镑，其中27亿英镑和56亿英镑分别用于管理愈合和未愈合的伤口。全国保健服务年度总费用的81%是在社区发生的。2012/2013年至2017/2018年间，伤口的年患病率增加了71%。在这段期间，资源的使用大幅增加，病人管理成本以真实的计算增加了48%。NHS内部需要进行结构性变革，以管理不断增长的伤口护理需求并改善患者结局。
To evaluate the prevalence of wounds managed by the UK’s National Health Service (NHS) in 2017/2018 and associated health outcomes, resource use and costs. Retrospective cohort analysis of the electronic records of patients from The Health Improvement Network (THIN) database. Primary and secondary care sectors in the UK. Randomly selected cohort of 3000 patients from the THIN database who had a wound in 2017/2018. Patients’ characteristics, wound-related health outcomes, healthcare resource use and total NHS cost of patient management. There were an estimated 3.8 million patients with a wound managed by the NHS in 2017/2018, of which 70% healed in the study year; 89% and 49% of acute and chronic wounds healed, respectively. An estimated 59% of chronic wounds healed if there was no evidence of infection compared with 45% if there was a definite or suspected infection. Healing rate of acute wounds was unaffected by the presence of infection. Smoking status appeared to only affect the healing rate of chronic wounds. Annual levels of resource use attributable to wound management included 54.4 million district/community nurse visits, 53.6 million healthcare assistant visits and 28.1 million practice nurse visits. The annual NHS cost of wound management was £8.3 billion, of which £2.7 billion and £5.6 billion were associated with managing healed and unhealed wounds, respectively. Eighty-one per cent of the total annual NHS cost was incurred in the community. The annual prevalence of wounds increased by 71% between 2012/2013 and 2017/2018. There was a substantial increase in resource use over this period and patient management cost increased by 48% in real terms. There needs to be a structural change within the NHS in order to manage the increasing demand for wound care and improve patient outcomes.
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影响因子：
2.9
作者：
Guest JF;Fuller GW;Vowden P;Vowden KR
通讯作者：
Vowden KR
影响因子：
1.9
作者：
Guest, J. F.;Vowden, K.;Vowden, P.
通讯作者：
Vowden, P.
影响因子：
1.9
作者：
Guest, J. F.;Fuller, G. W.;Vowden, P.
通讯作者：
Vowden, P.
影响因子：
1.9
作者：
Guest, J. F.;Taylor, R. R.;Vowden, P.
通讯作者：
Vowden, P.
影响因子：
1.9
作者：
Guest, J. F.;Ayoub, N.;Greaves, T.
通讯作者：
Greaves, T.