脑卒中患者住院费用及影响因素分析
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摘要
目的分析脑卒中患者住院费用构成及住院费用影响因素,为合理控制住院费用提供依据。方法采用描述性分析,非参数检验和多元线性回归等统计方法对2016年中山市脑卒中病例基本情况以及住院费用进行分析。结果脑卒中患者男10 955例,占总病例数的51.67%,女10 245例,占总病例数的48.33%,平均年龄(68.54±13.28)岁,年龄>60岁16 331例(77.03%),药品费(包括西药费和中药费)占总住院费用57.64%。影响住院费用的主要因素依次为住院天数、手术、脑卒中亚型、付款方式、年龄(P<0.01)。结论脑卒中患者的负担严重,建议采取加强对药物的科学合理使用、提升医务人员医疗技术和服务水平及缩短住院天数等措施控制医疗费用不合理增长,减少脑卒中患者的负担。
Objective To analyze the hospitalization expenses and influencing factors of stroke patients,and to provide evidence for reasonable control of hospitalization expenses.Methods Descriptive analysis,nonparametric test and multiple linear regression were used to analyze the basic situation and hospitalization expenses of stroke cases in Zhongshan city in 2016.Results There were 10 955 cases of man stroke patients,accounting for 51.67% of the total cases,and 10 245 cases of women,accounting for 48.33% of the total cases.The average age was(68.54±13.28)years old,and the majority of patients aged over 60 years old there were 16 331 cases,accounting for 77.03%,and the drug expenses(including western medicine fees and Chinese medicine fees) accounted for the largest proportion of total hospitalization expenses,which was 57.64%.The main factors affecting hospitalization expenses were hospitalization days,whether surgery,stroke subtype,payment method and age(P<0.01).Conclusion The burden of stroke patients is serious.It is recommended to strengthen the scientific and rational use of drugs,improve the medical technology and service level of medical staff,and shorten the length of hospital stay to control the unreasonable growth of medical expenses and reduce the burden on stroke patients.
Objective To analyze the hospitalization expenses and influencing factors of stroke patients,and to provide evidence for reasonable control of hospitalization expenses.Methods Descriptive analysis,nonparametric test and multiple linear regression were used to analyze the basic situation and hospitalization expenses of stroke cases in Zhongshan city in 2016.Results There were 10 955 cases of man stroke patients,accounting for 51.67% of the total cases,and 10 245 cases of women,accounting for 48.33% of the total cases.The average age was(68.54±13.28)years old,and the majority of patients aged over 60 years old there were 16 331 cases,accounting for 77.03%,and the drug expenses(including western medicine fees and Chinese medicine fees) accounted for the largest proportion of total hospitalization expenses,which was 57.64%.The main factors affecting hospitalization expenses were hospitalization days,whether surgery,stroke subtype,payment method and age(P<0.01).Conclusion The burden of stroke patients is serious.It is recommended to strengthen the scientific and rational use of drugs,improve the medical technology and service level of medical staff,and shorten the length of hospital stay to control the unreasonable growth of medical expenses and reduce the burden on stroke patients.
引文
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[2] 陈伟伟,高润霖,刘力生,等.《中国心血管病报告2016》概要[J].中国循环杂志,2017,32(6):521-530.DOI:10.3969/j.issn.1000-3614.2017.06.001.
[3] 周铨,吴燕飞,章成国,等.新发脑卒中患者住院费用构成及影响因素分析[J].热带医学杂志,2012,12(8):980-982,1013.
[4] 范冬冬,姚自勤,王锦权,等.参保脑卒中患者住院费用影响因素分析[J].中国公共卫生,2016,32(12):1745-1749.DOI:10.11847/zgggws2016-32-12-35.
[5] 张钰琪,武轶群,魏晨璐,等.北京2008-2012年缺血性脑卒中患者住院费用分析[J].中国公共卫生,2016,32(5):670-672.DOI:10.11847/zgggws2016-32-05-29.
[6] 岑鸿蕾,杨虹,陆伟江,等.广西两所三甲医院脑卒中患者住院次均费用构成及影响因素分析[J].中国慢性病预防与控制,2016,24(10):737-740.DOI:10.16386/j.cjpccd.issn.1004-6194.2016.10.005.
[7] Dewey HM,Thrift AG,Mihalopoulos C,et al.Lifetime Cost of Stroke Subtypes in Australia Findings From the North East Melbourne Stroke Incidence Study(NEMESIS)[J].Stroke,2003,34(10):2502-2507.DOI:10.1161/01.STR.0000091395.85357.09.
[8] 石玲燕,金嵘,郑荣远,等.温州地区脑卒中住院患者费用分析[J].中国公共卫生,2006,22(8):1022-1023.DOI:10.3321/j.issn:1001-0580.2006.08.072.
[9] 舒颖,罗艳侠,穆静,等.二级医院脑卒中患者医保住院费用调查及分析[J].中国预防医学杂志,2013,14(2):121-123.
[10] 曹英南,关天嘉,李晋磊,等.脑卒中患者住院费用及预后影响因素研究[J].中国卫生政策研究,2016,9(5):54-60.DOI:10.3969/j.issn.1674-2982.2016.05.010.