DETERMINANTS OF NURSING CARE COSTS & PATIENT OUTCOMES

护理费用的决定因素

• 批准号: 3392282
• 负责人: ADA K JACOX
• 金额: $ 2.86万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 1990
• 资助国家: 美国
• 起止时间: 1990-06-01 至 1990-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3392282
• 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

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.

该提案的总体目标是描述选定的患者和 影响护理费用的结构特征 社区医院。具体目标是：（1）确定如何进行总护理 住院费用根据患者特征（DRG、 护理诊断、疾病严重程度、年龄和付款方式）护理 工作人员和医生的特征； (2)如何确定患者的治疗结果 （依赖性、调整后的服务水平、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 医师特点； (3) 确定患者的结果是否 通过护理费用来预测。一种确定护理费用的方法 由 Higgerson 和 Van Slyck 在 1970 年代初开发（Higgerson & 范斯莱克，1982）。使用患者分类系统产生 病人护理单位（PCU）基于护理流程，直接成本 提供护理服务已确定。间接成本分配自 其他医院成本中心得出总护理费用。方法 已进行修改以反映当前的护理实践和成本并采用 用于十二家中西部医院，其中四家已同意 参与这项研究。 10 个高中各有 200 名受试者的样本量 预计 DRG 量。对数据的分析方法将是 多元回归框架，其中因变量为 衡量护理成本或患者结果的指标。