DETERMINANTS OF NURSING CARE COSTS AND PATIENT OUTCOMES

本提案的总体目标是描述选定的患者， 影响护理成本的结构特征 社区医院。具体目标是：（1）确定如何全面护理 住院费用由患者特征（DRG， 护理诊断、疾病严重程度、年龄和付款方式）护理 工作人员和医生特征;（2）确定患者结局 （依赖性，调整后的LOS，不良事件，护理满意度 护理和自我护理知识）由患者、护理人员和 医生特征;以及（3）确定患者结果是否 根据护理费用预测。护理成本的确定方法 是由Higgerson和货车Slyck在20世纪70年代早期开发的（Higgerson & 货车Slyck，1982）。使用患者分类系统， 病人护理单位（PCU）的基础上，护理过程中，直接成本 提供护理是有决心的。间接费用从 其他医院成本中心得出护理总成本。述的方法 已修改，以反映当前的护理实践和成本，并通过 在12家中西部医院使用，其中4家已同意 参与这项研究。样本量为200名受试者， 预计的DRG体积。对数据的分析方法将是 多元回归框架，其中因变量将是 无论是护理成本还是患者结果。

The overall objective of this proposal is to describe selected patient and structural characteristics that influence the cost of nursing care in community hospitals. Specific aims are: (1) to determine how total nursing cost of a hospital stay is predicted by patient characteristics (DRG, nursing diagnoses, severity of illness, age, and method of payment) nursing staff and physician characteristics; (2) to determine how patient outcomes (dependency, adjusted LOS, adverse incidents, satisfaction with nursing care and self care knowledge) are predicted by patient, nursing staff and physician characteristics; and (3) to determine if patient outcomes are predicted by cost of nursing care. A method for determining nursing costs was developed by Higgerson and Van Slyck in the early 1970's (Higgerson & Van Slyck, 1982). Using a patient classification system that produces patient care units (PCU) based on the nursing process, direct costs of providing nursing care are determined. Indirect costs are allocated from other hospital cost centers to arrive at a total nursing cost. The method has been modified to reflect current nursing practice and costs and adopted for use in twelve Midwestern hospitals, four of which have agreed to participate in this study. A sample size of 200 subjects in each of 10 high volume DRGs is projected. The analytic approach to the data will be a multiple regression framework in which the dependent variable will be either a measure of nursing cost or patient outcome.