[1]何孝崇 皮星 刘彬 顾春燕 汤帆帆 张索飞.社区失独家庭慢性病老人居家护理直接成本调查与分析[J].中国卫生质量管理,2021,28(06):075-78.[doi:10.13912/j.cnki.chqm.2021.28.6.20 ]
 HE Xiaochong,PI Xing,LIU Bin.Investigation and Analysis on the Direct Cost of Home Care for the Elderly with Chronic Diseases in Community Loss-of-Single-Child Families[J].Chinese Health Quality Management,2021,28(06):075-78.[doi:10.13912/j.cnki.chqm.2021.28.6.20 ]
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社区失独家庭慢性病老人居家护理直接成本调查与分析
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《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]

卷:
第28卷
期数:
2021年06期
页码:
075-78
栏目:
护理质量
出版日期:
2021-06-28

文章信息/Info

Title:
Investigation and Analysis on the Direct Cost of Home Care for the Elderly with Chronic Diseases in Community Loss-of-Single-Child Families
作者:
何孝崇 皮星 刘彬 顾春燕 汤帆帆 张索飞
陆军军医大学护理管理学教研室
Author(s):
HE XiaochongPI XingLIU Bin
Department of Nursing Administration,Army Medical University
关键词:
失独家庭慢性病老人居家护理护理直接成本
Keywords:
Loss-of-Single-Child Family Chronic Diseases ElderlyHome Care Direct Cost of Care
分类号:
R47;R197.6
DOI:
10.13912/j.cnki.chqm.2021.28.6.20
文献标志码:
A
摘要:
目的调查重庆市某主城区失独家庭慢性病老人居家护理服务直接成本,为社区护理服务成本管理提供参考。方法采用案例调查法和访谈法,以重庆市某主城区3个社区382名失独家庭老人和3个社区卫生服务中心124名护理人员为研究对象,确定失独家庭慢性病老人居家护理服务项目和成本构成要素,核算护理服务项目直接成本。结果共确定了22项护理服务项目,其中,糖尿病8项、高血压4项、冠心病5项、其他疾病5项;生命体征测量项目直接成本最低(1.5元),糖尿病伤口换药项目直接成本最高,在22.8元~57.0元之间。失独家庭慢性病老人居家护理服务项目中血糖监测、PICC维护及引流管护理盈利,其他项目处于亏损状态。结论护理服务项目计价标准较低,未能体现社区护理人员劳动价值;失独家庭扶助金标准较低,难以减轻居民经济负担;社区护理人员学历、职称不高,难以满足失独家庭慢性病老人心理需求。建议动态调整居家护理服务项目物价标准,提高失独家庭老人救助金标准,加强“互联网+社区护理”体系建设,完善人才队伍结构,有效利用社会资源。
Abstract:
ObjectiveTo investigate the direct cost of home care for the elderly from Loss-of-Single-Child families in a major urban area of Chongqing, and to provide reference for the cost management.MethodsThe case study and interview methods were used to investigate 382 elders from Loss-of-Single-Child families and 124 nurses from 3 community health service centers in a major urban area of Chongqing to determine the home care service items and cost components of the elderly, and calculate the direct cost.ResultsA total of 22 nursing service items were identified, including 8 for diabetes, 4 for hypertension, 5 for coronary heart diseases and 5 for other diseases. The direct cost of vital signs measurement was the lowest (1.5 yuan), and diabetic wound was the highest, between 22.8 yuan and 57.0 yuan. Blood glucose monitoring, PICC maintenance and drainage tube care in the home care service for the elderly with chronic diseases from Loss-of-Single-Child families were profitable, while other items were at a loss. Conclusion The price standard of nursing items was low, and it was difficult to reflect the labor value of community nursing staff; the subsidy standard for Loss-of-Single-Child families was low, it was difficult to reduce the economic burden of residents; the educational background and professional title of community nursing staff were not high, and it was difficult to meet the psychological needs of the elderly from Loss-of-Single-Child families. It was suggested that prices of home care services should be adjusted dynamically, subsidies for elderly in Loss-of-Single-Child families should be raised, the "Internet + community care" system should be strengthened, the structure of the talent pool should be improved, and social resources should be effectively utilized.

参考文献/References:

[1]熊亮.失独家庭差异化需求与“四位一体”精准扶助[J].甘肃社会科学,2019(5):187-193. [2]王景迁,方卫. 失独家庭社会救助现状与对策研究[J].北京大学学报:哲学科学社会版,2019,56(5):77-86. [3]陈文华. 两类失独家庭的社会支持比较研究 兼论失独自组织的影响[J].社会工作与管理,2017,17(5):63-72. [4]蔡慧琳,陈 睿. 城市失独家庭养老保障存在的问题及对策研究[J].市场周刊,2020,33(11):185-187. [5]南 菁,黄 鹂. 我国失独家庭现状及帮扶对策研究述评[J].合肥学院学报:社会科学版 ,2013,30(2):20-23. [6]金珑嘉.失独家庭现状及其养老问题研究[J].汕头大学学报:人文社会科学版 ,2013,29(4):75-78. [7]张 兰,王 影,杨玮,等.上海市某社区失独老人总体幸福感的分析[J].上海预防医学,2020,32(5):440-444. [8]李长明,董燕敏.国家基本公共卫生服务规范(第三版)操作手册[M].北京:金盾出版社,2017:1-100. [9]夏军.时间驱动作业成本法与RBRVS结合用于医院项目成本核算的研究[J].中国卫生质量管理,2019,26(2):113-116. [10]赖静. 基于DRGs为导向的ICU慢性阻塞性肺疾病患者护理服务成本研究[J].中西医结合护理,2019,5(3):1-5. [11]重庆市医疗保障局,重庆市卫生健康委员会,重庆市财政局,等.关于全面取消公立医疗机构医用耗材加成同步调整医疗服务项目价格的通知(渝医保[2019]81号)[EB/OL]. (2019-12-17).http://ylbzj.cq.gov.cn/zwgk_535/fdzdgknr/lzyj/xzgfxwj/202002/t20200220_5338680.html. [12]蒋红,顾妙娟,赵 琦.临床实用护理技术操作规范[M].上海:上海科学技术出版社,2019:1-30. [13]董昱,王桦,檀春玲,等.我国老年人四大慢性病流行现状及对伤残调整生命年的影响[J].医学与社会,2019,32(10):59-65. [14]中华人民共和国财政部. 人口计生委财政部关于印发全国独生子女伤残死亡家庭扶助制度试点方案的通知(国人口发〔2007〕78号)[EB/OL].(2007-08-31).http://jkw.mof.gov.cn/zhengwuxinxi/zheng cefabu/200806/t20080625_53511.html. [15]丁亚,丁玎,冯洁,等.大连市计划生育特殊家庭父母心理健康水平分析[J].卫生软科学,2020,34(4):65-68. [16]周小兰,李 静,李 菲,等.陕西省基层医疗卫生机构护理人员现状调查[J].中国卫生质量管理,2016,23(2):65-68. [17]Faria-López E, Estévez-Guerra GJ, Polo-Luque ML,et al.Physical restraint use with elderly patients: perceptions of nurses and nursing assistants in Spanish Acute Care Hospitals[J].Nurs Res,2018,67(1):55-59. [18]Griscti O, Aston M, Martin-Misener R,et al.The experiences of chronically ill patients and registered nurses when they negotiate patient care in hospital settings: a feminist poststructural approach: a qualitative study that explores negotiation of patient care between patients and chronically ill patients in hospital settings[J].J Clin Nurs,2016,25(13):2028-2039. [19]熊 亮,韩 冰.多元参与失独家庭困境化解探究 基于福利多元主义视角[J].辽宁行政学院学报,2020(6):49-53. [20]周 莹,马志敏, 陈志航,等.区域居民健康的慢病管理模式探索:以医联体糖尿病管理为例[J].中国卫生质量管理,2020,27(4):150-152.

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更新日期/Last Update: 2021-06-28