{"title":"Nursing Cost Analysis for Acute Exacerbation of Chronic Obstructive Pulmonary Disease in the Intensive Care Unit.","authors":"Haizhou Mao, Zhi Chen, Wei Li, Xinyue Pang, Xinmei Cao, Jiaqi Shi, Danwen Zhuang, Lijie Mao","doi":"10.1111/jocn.17603","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To determine nursing costs for intensive care unit (ICU) patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), assess the correlation with diagnosis-related group (DRG) payments and identify cost determinants.</p><p><strong>Design: </strong>Prospective, descriptive and quantitative study.</p><p><strong>Methods: </strong>From January to December 2022, we selected ICU patients with AECOPD and used time-driven activity-based costing method to calculate the overall nursing costs. We examined the cost recovery rate, correlations between nursing costs and DRG Relative Weight, and factors influencing nursing costs using nonparametric tests, Spearman's rank correlation and quantile regression.</p><p><strong>Results: </strong>The median nursing charge was US$1001.88, the median nursing cost was US$678.51, and the average cost recovery rate was 68.39%. Nursing costs correlated with the DRG Relative Weight but not with payments. Length of stay, oxygen therapy mode and noninvasive ventilator use days impacted costs.</p><p><strong>Conclusions: </strong>Nursing costs exceeded charges, with a moderate cost recovery rate. DRG payments do not fully reflect nursing cost variations.</p><p><strong>Relevance to clinical practice: </strong>Our findings indicate the need to enhance the reimbursement system for nursing costs and to manage ICU nursing expenses by addressing the determinants of these costs.</p><p><strong>Reporting method: </strong>The authors adhered to the EQUATOR network guidelines STROBE to report observational cross-sectional studies.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/jocn.17603","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
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Abstract
Objective: To determine nursing costs for intensive care unit (ICU) patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), assess the correlation with diagnosis-related group (DRG) payments and identify cost determinants.
Design: Prospective, descriptive and quantitative study.
Methods: From January to December 2022, we selected ICU patients with AECOPD and used time-driven activity-based costing method to calculate the overall nursing costs. We examined the cost recovery rate, correlations between nursing costs and DRG Relative Weight, and factors influencing nursing costs using nonparametric tests, Spearman's rank correlation and quantile regression.
Results: The median nursing charge was US$1001.88, the median nursing cost was US$678.51, and the average cost recovery rate was 68.39%. Nursing costs correlated with the DRG Relative Weight but not with payments. Length of stay, oxygen therapy mode and noninvasive ventilator use days impacted costs.
Conclusions: Nursing costs exceeded charges, with a moderate cost recovery rate. DRG payments do not fully reflect nursing cost variations.
Relevance to clinical practice: Our findings indicate the need to enhance the reimbursement system for nursing costs and to manage ICU nursing expenses by addressing the determinants of these costs.
Reporting method: The authors adhered to the EQUATOR network guidelines STROBE to report observational cross-sectional studies.
期刊介绍：
The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice.
JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice.
We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.
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