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DETERMINANTS OF NURSING CARE COSTS AND PATIENT OUTCOMES

护理费用和患者结果的决定因素

基本信息

批准号：
2256887
负责人：
ADA K JACOX
金额：
$ 22.05万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
1990
资助国家：
美国
起止时间：
1990-10-01 至 1995-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/2256887
关键词：
health care cost /financing hospital analysis hospital length of stay hospital patient care interview nurse patient relations nurses nursing care nursing care evaluation nursing diagnosis physicians self care self help

项目摘要

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.

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。具体目的是：（1）确定如何进行全程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。