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首页> 外文OA文献 >The cost-effectiveness of a patient centred pressure ulcer prevention care bundle: Findings from the INTACT cluster randomised trial.
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The cost-effectiveness of a patient centred pressure ulcer prevention care bundle: Findings from the INTACT cluster randomised trial.

机译：以患者为中心的预防压疮护理套装的成本效益：来自INTACT整群随机试验的结果。

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Pressure ulcers are serious, avoidable, costly and common adverse outcomes of healthcare. To evaluate the cost-effectiveness of a patient-centred pressure ulcer prevention care bundle compared to standard care. Cost-effectiveness and cost-benefit analyses of pressure ulcer prevention performed from the health system perspective using data collected alongside a cluster-randomised trial. Eight tertiary hospitals in Australia. Adult patients receiving either a patient-centred pressure ulcer prevention care bundle (n=799) or standard care (n=799). Direct costs related to the intervention and preventative strategies were collected from trial data and supplemented by micro-costing data on patient turning and skin care from a 4-week substudy (n=317). The time horizon for the economic evaluation matched the trial duration, with the endpoint being diagnosis of a new pressure ulcer, hospital discharge/transfer or 28days; whichever occurred first. For the cost-effectiveness analysis, the primary outcome was the incremental costs of prevention per additional hospital acquired pressure ulcer case avoided, estimated using a two-stage cluster-adjusted non-parametric bootstrap method. The cost-benefit analysis estimated net monetary benefit, which considered both the costs of prevention and any difference in length of stay. All costs are reported in AU$(2015). The care bundle cost AU$144.91 (95%CI: $74.96 to $246.08) more per patient than standard care. The largest contributors to cost were clinical nurse time for repositioning and skin inspection. In the cost-effectiveness analysis, the care bundle was estimated to cost an additional $3296 (95%CI: dominant to $144,525) per pressure ulcer avoided. This estimate is highly uncertain. Length of stay was unexpectedly higher in the care bundle group. In a cost-benefit analysis which considered length of stay, the net monetary benefit for the care bundle was estimated to be -$2320 (95%CI -$3900, -$1175) per patient, suggesting the care bundle was not a cost-effective use of resources. A pressure ulcer prevention care bundle consisting of multicomponent nurse training and patient education may promote best practice nursing care but may not be cost-effective in preventing hospital acquired pressure ulcer.
机译：压疮是严重的，可避免的，昂贵的并且是医疗保健的常见不良后果。与标准护理相比，评估以患者为中心的压疮预防护理套装的成本效益。从卫生系统的角度，使用与整群随机试验一起收集的数据，对预防压疮进行了成本效益和成本效益分析。澳大利亚有八家三级医院。成年患者接受以患者为中心的压疮预防护理包（n = 799）或标准护理（n = 799）。从试验数据中收集与干预和预防策略相关的直接费用，并通过为期4周的子研究（n = 317）补充有关患者轮换和皮肤护理的微观费用数据。经济评估的时间范围与试验持续时间相符，终点为诊断出新的压疮，出院/转院或28天。以先发生者为准。对于成本效益分析，主要结局是采用两阶段聚类调整的非参数自举法估算的每增加一个医院获得的压疮病例，每增加一例避免的预防性预防费用，其增量成本就会增加。成本效益分析估算了净货币收益，其中既考虑了预防成本，又考虑了停留时间的任何差异。所有费用均以澳元（2015）报告。与标准护理相比，每名患者的护理套餐费用为AU $ 144.91（95％CI：74.96美元至246.08美元）。费用的最大贡献者是临床护士重新定位和皮肤检查的时间。在成本效益分析中，每避免一个褥疮，该护理包估计需要额外花费$ 3296（95％CI：占主导地位的$ 144,525）。此估计高度不确定。护理组合组的住院时间出乎意料地更长。在考虑住院时间的成本效益分析中，该护理套组的净货币收益估计为每位患者-2320美元（95％CI-$ 3900，-$ 1175），这表明该护理套组不是一种划算的用途资源。由多方面护士培训和患者教育组成的压疮预防保健服务可能会促进最佳实践护理，但在预防医院获得性压疮方面可能并不划算。

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