安徽省某医院2012-2016年冠心病患者PCI手术住院费用分析

摘要

目的:分析近年冠心病(CHD)经皮冠脉介入治疗(PCI)手术患者住院费用情况及其影响因素.方法:收集2012-2016年安徽省某家三甲医院冠心病PCI手术患者住院费用数据,统计分析住院费用的变化情况和影响因素.结果:行PCI手术的CHD住院患者人数呈现逐年上升趋势.自2012年起至2016年,次均检查费逐年上升(2012与2013年比较除外),次均药费、次均床位费及其他费用(2013和2014年比较除外) 、次均住院时间逐年下降(2012与2013年比较,2014与2015年比较除外),两两比较有显著差异,P＜0.05或＜0.01.全公费参保的患者次均住院费用最高.男性组仅次均药费[5368.66 (3831.01,7974.22 )元比5045.16 (3721.97,7308.26)元]显著高于女性组( P＝ 0.019 ).50 ～ 70 岁组次均治疗费[ (36351.63 (27925.86,47714.41 )元比 34622.20 (27296.66,46504.87)元]显著高于≤50岁组,P＝0.024;与≤50岁组和50～70岁组比较,＞70岁组各项费用均显著升高,P＜0.05或＜0.01.与住院时间≤7d组比较,7～14d组和＞14d组各项费用均显著升高,且＞14d组的显著高于7～14d组的,P均＝0.001.多元线性回归分析显示住院时间是冠心病PCI患者住院费用的独立危险因素(β＝0.461,P＝0.001),而参保方式是其独立保护因素(β＝ -0.078,P＝0.001).结论:冠心病PCI手术患者住院费用经济负担仍较重,需提高疗效,减少住院时间,减轻患者经济负担.%Objective:To analyze hospitalization cost of patients with coronary heart disease (CHD) undergoing per-cutaneous coronary intervention (PCI) in recent years and its influencing factors.Methods:Hospitalization cost data of CHD patients undergoing PCI in a hospital of Anhui province from 2012 to 2016 were collected.Changes of hos-pitalization costs and its influencing factors were statistically analyzed.Results:Number of hospitalized CHD pa-tients undergoing PCI gradually rose year by year.From 2012 to 2016,there was significant rise in mean examina-tion fee per time (except 2012 vs.2013),significant reductions in mean medicine fee per time,mean bed fee and other fees (except 2013 vs.2014 ) and mean hospitalization duration per time (except 2012 vs.2013,2014 vs.2015),P＜0.05 or ＜ 0.01.Patients with full public insurance possessed the highest mean hospitalization fee per time.Mean medicine fee per time of male group was significantly higher than that of female group [5368.66 (3831.01,7974.22) RMB vs.5045.16 (3721.97,7308.26) RMB],P＝0.019.Mean treatment fee per time of 50～70 years group was significantly higher than that of ≤50 years group [ (36351.63 (27925.86,47714.41) RMB vs.34622.20 (27296.66,46504.87) RMB],P＝0.024;compared with ≤50 years group and 50～70 years group,there were significant rise in all fees in ＞70 years group,P＜0.05 or ＜0.01.Compared with hospitalization ≤7d group,there were significant rise in all fees in 7～14d group and ＞14d group,and those of ＞14d group were signif-icantly higher than those of 7～14d group,P＝0.001 all.Multifactor linear regression analysis indicated that hospi-talization duration was independent risk factor for hospitalization fee of CHD patients undergoing PCI (β＝0.461,P＝0.001),while insurance way was its independent protective factor (β＝ -0.078,P＝0.001).Conclusion:Eco- nomic burden of CHD inpatients undergoing PCI is still heavy,we must improve theraputic effect,reduce hospital stays,in order to reduce patients′economic burden.