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Cost of care for seniors hospitalized for hip fracture and related procedures.
- Source :
-
Nursing outlook [Nurs Outlook] 2007 Jan-Feb; Vol. 55 (1), pp. 5-14. - Publication Year :
- 2007
-
Abstract
- Hospitalization and treatment for hip fracture and elective hip replacement surgery are increasing as the number of elderly increases and with new surgical breakthroughs. Little research has been conducted on the interventions and other variables that impact cost of care; no research has been published that includes the impact of nursing care on hospital cost. To explain the cost of hospital care that includes nursing interventions for an older patient population hospitalized for a hip fracture and/or related procedure. An effectiveness research model composed of patient characteristics, clinical conditions, nursing unit characteristics, medical, pharmacy, and nursing interventions related to the outcome of hospital cost was tested using GEE analysis. The analysis included 195 variables systematically reduced to 71 that were then examined in a sample of 568 hospitalizations (n = 523 patients, > or = 60 years old) admitted for treatment of a hip fracture or elective hip procedure over a 4-year period. Data were obtained retrospectively from nine clinical and administrative data repositories from one tertiary care hospital. The best predictors of increased hospital cost were the nursing intervention of Tube Care, the level of RN staffing below the unit's average, total number of medical procedures, total number of different medications, and low levels of the nursing intervention of Surgical Preparation. More RN hours per patient day and some nursing interventions were associated with reduced cost. The study demonstrates the importance of conducting effectiveness research in nursing. Some nursing interventions were associated with increased cost and some with decreased cost, but when compared with medical and pharmacy interventions, fewer nursing interventions were associated with increased cost. Inadequate RN staffing raised cost whereas increased RN staffing was associated with lower costs.
- Subjects :
- Aged
Analysis of Variance
Arthroplasty, Replacement, Hip nursing
Clinical Competence
Comorbidity
Cost of Illness
Cost-Benefit Analysis
Diagnosis-Related Groups economics
Direct Service Costs statistics & numerical data
Female
Hip Fractures epidemiology
Hip Fractures therapy
Hospital Charges statistics & numerical data
Humans
Length of Stay economics
Linear Models
Male
Models, Econometric
Nurse's Role
Nursing Administration Research
Nursing Staff, Hospital economics
Nursing Staff, Hospital supply & distribution
Personnel Staffing and Scheduling economics
Retrospective Studies
Workload economics
Arthroplasty, Replacement, Hip economics
Hip Fractures economics
Hospital Costs statistics & numerical data
Hospitalization economics
Subjects
Details
- Language :
- English
- ISSN :
- 0029-6554
- Volume :
- 55
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Nursing outlook
- Publication Type :
- Academic Journal
- Accession number :
- 17289462
- Full Text :
- https://doi.org/10.1016/j.outlook.2006.06.006