广东省某三甲医院房间隔缺损和室间隔缺损患者住院状况分析  

Hospital situation in patients with atrial septal defects and ventricular septal defects in a top three hospital of Guangdong province

作　　者：祁娟[1,2] 石美玲[1] 邓木兰[1] 江夏杏[1] 程云清[1] 陈寄梅[1] 庄建[1] 李河 张丕德[2] 

机构地区：[1]广东省心血管病研究所广东省人民医院广东省医学科学院,广州510080 [2]广东药学院公共卫生学院,广州510224

出　　处：《岭南心血管病杂志》2014年第2期218-222,共5页South China Journal of Cardiovascular Diseases

基　　金："十二五"国家科技支撑计划项目(编号:2011BAI11B22);广东省科技计划项目(编号:2011B031800009)

摘　　要：目的 通过对广东省某三甲医院2003年1月至2011年12月房间隔缺损（房缺）和室间隔缺损（室缺）患者住院状况分析,研究先天性心脏病（先心病）住院费用的影响因素,为房缺和室缺患者疾病经济负担控制提供建议.方法 按照房缺和室缺的临床诊断标准,排除有次要诊断的患者,回顾性分析2003年至2011年房缺和室缺患者的住院状况资料.结果 2003年至2010年间房缺患者和室缺患者以儿童为主（86.2％）,男女比为1.34∶1,房缺和室缺的治愈率分别为99.4％和98.6％,房缺和室缺的住院费用在30 001～43 000元为主,性别X1、年龄X2、住院年份X3、住院天数X4、手术方式X5是影响房缺和室缺患者住院费用的主要因素,其Logistic回归模型房缺为logit2/1 =795.893 ＋0.792X2-0.393X3 ＋0.853X4-3.375X5和logit3/1 =2 236.254 ＋0.787X2-1.107X3 ＋1.464X4-7.762X5;室缺为logit2/1 =444.432-0.2 270.324 X3 ＋0.844 X4＋3.365X5,logit3/1 =1 277.419 ＋0.517X2 ＋0.135X3-0.135X4-3.435X5.结论 房缺和室缺患者住院费用逐年下降（β＜0）,应结合可控因素与不可控因素,进一步降低住院费用.Objectives To investigate the factors that influence the hospitalization costs of congenital heart disease through the analysis of hospital situation in patients with atrial septal defects and ventricular septal defects in a top three hospital of Guangdong province from the January 2003 to December 2011, and to give suggestions of economic burden controlling for patients. Methods Patients were diagnosed by clinical diagnostic criteria and those with a secondary diagnosis were excluded. The data of hospital situation from 2003 to 2011 was analyzed retrospectively. Results Patients with atrial septal defects and ventrieular septal defects were mainly children （86.2%）, and the gender ratio was 1.34：1 （male versus female）. The cure rates of atrial septal defects and ventricular septal defects were 99.4% and 98.6% respectively. Hospitalization costs were mainly between RMB 30 001 yuan and 43 000 yuan. Hospitalization costs were mostly influenced by gender （X1）, age （X2）, the year in hospital （X3）, duaration （X4） and operation methods （X5）. The Logistic regression models were logit2/1 =795.893＋0.792Xz-0.393X3＋0.853X4-3.375Xs, logit3/1 =2 236.254＋0.787X2- 1.107X3＋ 1.464X4-7.762Xs for atrial septal defects ; and logit2/1 =444.432-0.2 270.324X3＋0.844X4＋3.365Xs, logit3/1 = 1 277.419＋0.517X2＋0.135X3-0.135X4-3.435X5 for ventricular septal defects. Conclusions Hospitalization costs of atrial septal defects and ventricular septal defects are declining year by year （13 〈0）. Controllable factors and uncontrollable factors should be combined in order to reduce the hospitalization costs further.

关 键 词：房间隔缺损 室间隔缺损 住院费用 

分 类 号：R541.7[医药卫生—心血管疾病]