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  

Composition and influencing factors of average hospitalization expenses of patients with stroke in two tertiary hospitals of Guangxi

作　　者：岑鸿蕾 杨虹[1] 陆伟江[1] 黄颖[1] 孟军[1] 罗水英[1] 许晶晶[1] 蔡剑锋[1] CEN Hong-lei YANG Hong LU Wei-jiang HUANG Ying MENG Jun LUO Shui-ying XU Jing-jing CAI Jian-feng(Guangxi Center of Disease Prevention and Control, Nanning, Guangxi 530028, Chin)

机构地区：[1]广西壮族自治区疾病预防控制中心慢性病防制所,广西南宁530028

出　　处：《中国慢性病预防与控制》2016年第10期737-740,745,共5页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：广西壮族自治区卫计委项目(Z2014156)

摘　　要：目的分析脑卒中患者住院费用构成及影响因素,为合理控制脑卒中医疗费用,减轻个人和社会的经济负担提供参考依据。方法收集广西2所三级医疗机构2003年、2008年和2013年脑卒中住院患者的6 080例完整病历资料进行回顾性分析。采用非参数检验对脑卒中患者住院费用的影响因素进行单因素分析,用多元线性逐步回归分析进行多因素分析。结果 6 080例脑卒中住院患者男性(67.22%)多于女性(32.78%),脑梗死(80.82%)多于脑出血(18.03%)。患者实际住院天数中位数为12 d,次均住院费用中位数为12 543.80元,脑卒中患者住院次均费用是总住院患者次均费用的1.40倍,其中2003年、2008年、2013年脑卒中患者次均住院费用分别为7 639.41、8 685.97和15 589.24元,3个年度的费用呈逐渐增加的趋势,差异均有统计学意义(χ2=2 780.976,P<0.01)。扣除物价影响因素后,自2004年以来,10年间广西脑卒中患者次均住院费用年增长速度为4.59%。各类费用构成中以药品类所占比例最高(46.97%),单项费用中以西药费、检查诊断费较高,分别为46.17%、23.99%。影响住院费用的主要因素依次为实际住院天数、手术治疗、脑卒中亚型、合并2型糖尿病(T2DM)。结论广西三甲医院脑卒中患者住院费用明显高于全国的平均水平,且费用构成不合理。规范医院管理,缩短无效住院日,严格控制病情,可有效减少患者的住院费用,减轻脑卒中直接经济负担。Objective To analyze the composition and influencing factors of hospitalization expenses in patients with stroke, and to provide the reference for reasonable controlling of medical expenses and reducing the economic burden of individuals and society. Methods A retrospective analysis was performed on the complete data of 6 080 patients with stroke in two tertiary hospitals of Guangxi in 2003, 2008 and 2013.The t-test and variance analysis were used for single factor of hospitalization expenses in patients with stroke, and the multiple linear stepwise regression analysis was utilized for the multifactor analysis of influencing factors. Results In 6 080 patients with stroke（the male： 67.22%, female： 32.78%）, the cerebral infarction cases（80.82%）was more than the cerebral hemorrhage cases（18.03%）.The median of actual length of hospital stay was 12 days,the average hospitalization expenses median were 12 543.80 Yuan, the average hospitalization expenses of stroke patients were 1.40 folds of the total average hospitalization expenses, the average hospitalization expenses of stroke patients in 2003, 2008 and 2013 were 7 639.41, 8 685.97 and 15 589.24 Yuan, respectively. The average hospitalization expenses of stroke patients increased yearly（P〈0.01）. After deducting price factors,since 2004 the increase rate of average hospitalization expenses of stroke patients during 10 years was 4.59%. In the composition of all expenses, the proportion of medications was the highest（46.97%）. In single cost, the proportions of western medications and examinations were higher（46.17% and 23.99%）. The main influencing factors of the hospitalization expenses were the actual length of hospital stay, operation, stroke subtype and combined T2 DM. Conclusion The hospitalization expenses of patients with stroke in the tertiary hospitals of Guangxi are significantly higher than the average level of the whole country, and the cost is not reasonable. Standardize hospital management, shorten invalid hospitalization da

关 键 词：脑卒中 住院费用 构成 影响因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]