某中医医院缺血性脑卒中患者住院费用影响因素分析

摘要

Objective To analyze the effect of some factors represented by comorbidities on the hospitalization costs of patients with ischemic stroke. Methods Using medical record home page to conduct statistical description and single factor analysis of hospitalization costs and comorbidities of 5695 cases of hospitalized patients with ischemic stroke in a certain tertiary traditional Chinese medicine hospital in Beijing from 2012 to 2014. Multiple linear regression model was used to evaluate the effect of some factors represented by comorbidities on the hospitalization costs. Results The average cost of hospitalization for patients was 13557.67 yuan. Age, gender, payment methods, year of discharged, the length of hospital stay, the times of hospitalization, ADL score on admission, diabetes, hyperlipidemia, hypertension, pulmonary infection were impact factors in the hospitalization cost. After controlling other factors, patients with pulmonary infection were charged 11.40% higher than those without merger(P＜0.001),patients with diabetes were charged 3.05% higher than those without merger(P＜0.001),patients with hyperlipidemia were charged 2.94% higher than those without merger(P＜0.001),patients with hypertension were charged 1.51% higher than those without merger(P=0.035).Drug costs constitute an important factor in the increase of hospitalization costs. Conclusion Related departments should focus on the controllable factors of the occurrence and rehabilitation of stroke, and reduce the impact of these factors on the hospitalization cost. Controlling comorbidities is an important method to reduce the economic burden of ischemic stroke patients.%目的 探讨以合并症为代表的部分因素对缺血性脑卒中患者住院费用的影响.方法 利用病案首页数据对2012年-2014年北京市某三级中医医院5695例缺血性脑卒中患者住院费用和合并症情况进行统计描述和单因素分析,应用多元线性回归模型研究合并症等因素对住院费用的影响.结果 患者平均住院费用为13 557.67元.住院费用的影响因素包括年龄、性别、支付方式、出院年份、住院天数、住院次数、入院日常生活能力评定量表得分、糖尿病、高脂血症、高血压、肺部感染.在控制其他因素的前提下,合并肺部感染患者住院费用较不合并者高11.40%(P＜0.001),合并糖尿病患者住院费用较不合并者高3.05%(P＜0.001),合并高脂血症患者住院费用较不合并者高2.94%(P＜0.001),合并高血压患者住院费用较不合并者高1.51%(P=0.035).药费是造成住院费用增加的重要因素.结论 应重点关注与脑卒中的发生、康复相关的可控因素,降低这些因素对住院费用的影响,控制合并症是减轻缺血性脑卒中患者经济负担的一个重要途径.