早产儿发展性照顾与传统护理模式的费用效果分析

The cost-effect analysis of developmental care and traditional nursing mode in preterm

目的对早产儿发展性照顾护理和传统护理措施进行评价,为进一步提高早产儿的治疗效果,指导干预策略的改进,降低家庭卫生费用负担。方法通过收集2014年1月至2017年12月我院住院的早产儿护理资料,根据不同护理措施分为发展性照顾护理组(实验组)和传统护理模式组(对照组),2014年1月-2016年6月收治的早产儿采用传统护理模式(对照组),2016年7月至2017年12月收治的早产儿采用发展性照顾护理方案进行干预(观察组),组内按患儿周龄划分为26~30^(+6)周,31~34^(+6)周以及35~36^(+6)周三组,比较住院治疗指标、并发症发生率以及直接医疗费用的差异。结果除26~30^(+6)周患儿的开始经口进食时间、静脉营养天数及35~36^(+6)周患儿的住院天数较对照组无差异(P>0.05)外,试验组中不同周龄早产儿的呼吸机时间、持续正压通气时间、开始经口进食时间、静脉营养天数、体重增长、住院天数均较对照组有明显缩短(P<0.05)。两组早产儿在气胸、呼吸机相关性肺炎、真菌感染、NEC、ROP以及死亡等并发症差异无统计学意义(P>0.05)。除26~30^(+6)周患儿住院总费用及35~36^(+6)周患儿机械通气费用、静脉营养费用、抗生素费用、检查费、住院总费两组无显著差异(P>0.05)外,试验组中不同周龄早产儿的机械通气费用、静脉营养费用、抗生素费用、留置针费用、检验费、检查费以及住院总费用均显著降低(P<0.05)。结论发展性照顾护理可缩短不同周龄的早产儿的住院治疗时间,降低治疗费用,具有推广价值。

Objective Preterm birth is among the top causes of death in infants worldwide,and is great risk for short and long term complications,including impediments in growth and mental development.This study was designed to compare the cost and effect in preterm between developmental care and traditional care.Methods The data of nursing care of premature infants in our hospital from January 2014 to December 2017 were collected.According to different nursing strategies and measures,they were divided into developmental care group（ experimental group） that treated from January 2014 to June 2016 and traditional nursing group（ control group） that treated from July 2016 to December 2017.And the patients were divided into three groups： 26 - 30^＋6 weeks,31 - 34^＋6 weeks and 35 - 36^＋6 weeks according the characteristic of different age. The hospitalization parameters,the incidence of complications and direct medical costs were compared in the study.Results In addition to 20 - 30^＋6 weeks with oral intake time,parenteral nutrition and 35 - 36^＋6 weeks in hospital time compared with the control group had no difference（ P〉0. 05）.Different weeks premature in the experimental group in ventilator time,CPAP time,food intake time,intravenous nutrition days,weight gain,the days of hospitalization were lower than the control group significantly shortened（ P〈0. 05）.There was no significant difference between the two groups of preterm infants in pneumothorax,ventilator associated pneumonia,fungal infection,NEC,ROP and death（ P〉0. 05）. Different weeks premature in experimental group the costs of mechanical ventilation,intravenous nutrition and antibiotics,indwelling needle fees,blood test fees,the inspection fee and total cost of hospitalization was significantly lower（ P〈0. 05）.However,there were no significant difference between the experimental group and the control group in the total hospitalization expenses with 26 - 30^＋6 weeks premature and the cost of the costs of mechanical ventilation,intravenous nutrition,antibiotics,inspection and hospitalization.Conclusion The developmental care is helpful of reducing the time in hospital and the cost of treatment,and is worthy of promotion.