脑梗死患者住院医疗费用及影响因素的通径分析
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摘要
目的探寻影响脑梗死患者住院医疗费用的关键因素,为降低患者疾病经济负担、抑制医疗费用的过快上涨提供参考依据。方法从某三级甲等医院HIS系统收集2 360例主要诊断为脑梗死的出院患者医疗费用明细,描述性分析脑梗死患者基本情况及其医疗费用构成情况,利用多元线性回归模型及通径分析方法探寻影响脑梗死患者住院医疗费用的关键因素。结果影响脑梗死患者医疗费用的关键因素是药品费用及住院天数,而付费方式、是否手术、入院病情、转归情况和出院时期对医疗费用影响次之,并且通过住院天数间接影响住院医疗费用;患者性别、民族、婚姻状况及其年龄仅仅通过影响药品费用来间接地影响住院医疗费用。结论药品费用及其住院天数是影响脑梗死患者医疗费用的关键因素,在控制脑梗死患者医疗费用时,应通过控制其药品使用,在保证疗效的基础上缩短患者住院天数。
Objective To explore the key factors affecting the hospitalization expense of patients with cerebral infarction in an attempt to provide evidence for reducing the economic burden of patient and restraining the rapid increase in health care costs. Method Data on the medical expenditures in 2 360 hospitalized patients with cerebral infarction were retrospectively collected from the HIS system of a tertiary class A hospital. The demographic information of these patients and the compositions of medical expenses were analyzed descriptively. The key factors affecting the hospitalization expenses of patients with cerebral infarction were investigated using multivariate linear regression model and path analysis. Result The key factors affecting the medical expenses of patients with cerebral infarction included drug expenses and hospitalization days, followed by method of payment, surgery, disease condition at admission, patient outcome, and discharge date. Hospitalization days could indirectly affect the drug expenses. Gender, ethnic group, marital status, and age of the patients only had an indirect impact on hospitalization cost by affecting the drug expenses. Conclusion The key factors affecting the medical expenses of patients with cerebral infarction are drug expenses and hospitalization days. Controlling drug prescriptions and shortening hospital stay without compromising therapeutic efficacy may lower the medical expenses of patients with cerebral infarction.
Objective To explore the key factors affecting the hospitalization expense of patients with cerebral infarction in an attempt to provide evidence for reducing the economic burden of patient and restraining the rapid increase in health care costs. Method Data on the medical expenditures in 2 360 hospitalized patients with cerebral infarction were retrospectively collected from the HIS system of a tertiary class A hospital. The demographic information of these patients and the compositions of medical expenses were analyzed descriptively. The key factors affecting the hospitalization expenses of patients with cerebral infarction were investigated using multivariate linear regression model and path analysis. Result The key factors affecting the medical expenses of patients with cerebral infarction included drug expenses and hospitalization days, followed by method of payment, surgery, disease condition at admission, patient outcome, and discharge date. Hospitalization days could indirectly affect the drug expenses. Gender, ethnic group, marital status, and age of the patients only had an indirect impact on hospitalization cost by affecting the drug expenses. Conclusion The key factors affecting the medical expenses of patients with cerebral infarction are drug expenses and hospitalization days. Controlling drug prescriptions and shortening hospital stay without compromising therapeutic efficacy may lower the medical expenses of patients with cerebral infarction.
引文
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[11]李田,马利.中医院脑梗死患者住院医疗费用的通径分析[J].卫生经济研究,2017(10):33-36.
[12]杜连连,吴巍.脑梗死患者住院医疗费用及影响因素的通径分析[J].中国全科医学,2014, 17(1):71-74.
[13]蔡涛,韩燕,李辉,等. 2014年-2016年脑卒中患者住院费用影响因素通径分析[J].中国病案,2017, 18(5):59-62.
[2]中国健康网.2015年脑梗死发病率报告[EB/OL].(2015-11-05)[2018-06-08]. http://www.400jk.com/90000/86296.shtml.
[3]胡丹,贺伟. 2007-2011年某三甲医院脑梗死住院医疗费用构成及影响因素分析[J].中国卫生统计,2014, 31(4):707-709.
[4]魏亚卿,李育民,王晓茹,等.糖尿病患者住院费用及影响因素的通径分析[J].中国卫生经济,2018, 37(4):67-70.
[5]魏亚卿,李育民,裴正学,等.胃癌患者住院费用及影响因素的通径分析[J].中国肿瘤,2018, 27(8):596-600.
[6]袁晓丽,王汇平.贵州省医务人员亚健康影响因素通径分析[J].现代预防医学,2016, 43(12):2152-2155.
[7]常玲,赵永钢.陕西农村地区学龄儿童智力发育影响因素通径分析[J].中国学校卫生,2017, 38(2):235-237.
[8]邹胜男,丁宏.安徽省—年新型农村合作医疗脑梗死患者住院医疗费用分析[J].中国卫生经济,2015, 34(5):72-74.
[9]范冬冬,李爽.脑梗死患者住院医疗费用影响因素的通径分析[J].现代预防医学,2016, 43(7):1227-1230, 1249.
[10]万宇,张俊.影响缺血性卒中患者住院总天数及费用的相关因素分析[J].实用医学杂志,2014, 30(9):1420-1423.
[11]李田,马利.中医院脑梗死患者住院医疗费用的通径分析[J].卫生经济研究,2017(10):33-36.
[12]杜连连,吴巍.脑梗死患者住院医疗费用及影响因素的通径分析[J].中国全科医学,2014, 17(1):71-74.
[13]蔡涛,韩燕,李辉,等. 2014年-2016年脑卒中患者住院费用影响因素通径分析[J].中国病案,2017, 18(5):59-62.