28096例儿童住院疾病谱及费用分析  

Analysis on the Disease Spectrum and Hospitalization Expenses of 28096 Children

作　　者：匡寒琴[1] 

机构地区：[1]上海市儿童医院上海交通大学附属儿童医院,上海市200062

出　　处：《中国病案》2016年第1期53-55,共3页Chinese Medical Record

摘　　要：目的探讨儿童住院疾病谱及住院费用情况,为制定卫生医疗保障制度,更加合理分配医疗资源提供科学依据。方法资料来源于某儿童专科医院2014年所有出院病人28 096例,按患者年龄、疾病种类、住院天数等进行费用分析。结果患者平均住院日为6.73天,人均住院费用10 167.57元。各年龄组构成中,以学龄期病例最多,各年龄组费用比较有统计学意义;住院前3位疾病系统分别为:新生儿疾病、呼吸系统疾病和普外科疾病,在单因素方差分析中,显著性检验的P>0.05,说明出院儿童疾病系统前3位在出院费用上没有显著性差异;出院前5位的疾病分别为:肺炎、腹股沟斜疝、阻塞性睡眠呼吸暂停综合征、隐匿性阴茎和新生儿高胆红素血症,其中最多的为肺炎;住院天数费用分析表明,不同住院天数组费用差异有显著差异(x^2=19066.597,P<0.001)。住院费用与住院天数呈明显正相关。住院天数在9天以内占76.5%。结论儿童呼吸系统生理和免疫特点决定了儿童易患呼吸系统感染;先天性畸形多发也符合儿童疾病谱的特点;新生儿疾病又与新生儿本身生理特点及其形成原因的复杂性有关。因此控制医疗费用增长,缩短住院天数,加强疾病预防和卫生宣教,较少呼吸系疾病的发生和传染,同时做好母婴健康宣教和产前检查工作,从而减少先天性畸形率和新生儿疾病的发生。Objective To investigate the disease spectrum and hospitalization expenses of children, and provide scientific basis for formulating health care security system and making allocation of medical resource more reasonably. Methods The data were get from 28096 cases of all the discharged patients in a children hospital in 2014,and making expense analysis according to the items of age, disease entities and hospitalization length of stay and so on. Results The average length of hospital stay was 6.73 days, the average hospitalization expense was 10167.57 yuan. The school age group had the most patients in all the age group, it had statistical significance in the comparison of all the groups. The top 3 diseases systems included neonatal diseases, respiratory diseases and surgery diseases respectively, it had statistical significance in the single factor variance analysis（P〉0.05）, which indicated have no significant difference in the top 3 systems of discharged children＇s diseases. The top 5 discharged diseases were pneumonia, inguinal hernia, obstructive sleep apnea syndrome, concealed penis and neonatal hyperbilirubinemia,most of them were pneumonia hospitalization expenses. The expense analysis on the hospitalization days indicated that it had significant differences in different length of stay groups（X2=19066.597,P〈0.001）. The hospitalization expenses and hospitalization days were significantly positively correlated, the length of hospital stay within 9 days accounted for 76.5%. Conclusions The physiological and immune characteristics of respiratory system in children determine that children are prone to respiratory infection.The multiple congenital malformations are also in line with the characteristics of children＇s disease spectrum. So control the growth of medical expenses,to shorten the length of hospital stay, to strengthen disease prevention and health education,less respiratory disease occurrence and infection.At the same time,we should do well in maternal and child health education and prenat

关 键 词：儿童 住院 疾病谱 费用 

分 类 号：R197.5[医药卫生—卫生事业管理]