Charlson合并症指数对COPD患者住院时间、住院费用及院内死亡的影响  

The Influence of Charlson Comorbidity Index on Length of Stay,Cost of Hospitalization and In-hospital Death in Patients with COPD

作　　者：张倩[1] 李晶华[1] 马天娇[1] 张莉[1] 张瑞洁 李欣茹 邵玮娅 马京玉 ZHANG Qian(School of Public Health,Jilin University,Changchun,Jilin,130021,China)

机构地区：[1]吉林大学公共卫生学院,吉林长春130021

出　　处：《医学与社会》2021年第8期73-78,共6页Medicine and Society

基　　金：中国医学科学院基础医学研究所支持项目“利用医院数据、监测数据和现场调查验证非传染性慢性疾病患病情况”,编号为2017(146);中国医学科学院基础医学研究所支持项目“长春市居民慢性病经济负担研究”,编号为2018(869)。

摘　　要：目的:探讨COPD患者Charlson合并症指数(CCI)对其住院时间、住院费用及院内死亡的影响,为COPD精细化医保付费和控费提供理论依据。方法:收集吉林省某市2015-2017年COPD住院患者的病历首页信息。采用χ2检验和非参数检验分析COPD住院患者不同CCI分组的人口学和疾病特征,采用多重线性回归分析CCI对住院天数和住院费用的影响,并通过Poisson回归分析CCI对院内死亡的影响。结果:婚姻状况、年龄、是否手术、是否转科、入院病房、住院次数等对CCI有显著影响(P<0.05),CCI≥2分组相比0-1分组住院时间更长,住院费用更多,院内死亡率更高;控制单因素分析有统计学意义的变量后,CCI仍是影响COPD患者住院时间、住院费用及院内死亡的因素,高CCI评分与较差预后有关(P<0.05)。结论:CCI与COPD患者住院时间、住院费用及院内死亡显著相关。应大力加强COPD患者的筛查,强化基层医疗卫生机构对COPD患者的慢性病管理,从而减轻COPD及合并症带来的疾病负担。Objective:To explore the influence of Charlson Comorbidity Index(CCI)on length of stay,cost of hospitalization and in-hospital death in patients with Chronic Obstructive Pulmonary Disease(COPD),so as to provide a theoretical basis for COPD fine medical insurance payment and cost control.Methods:The data of the home page information of COPD inpatients from 2015 to 2017 in a city of Jilin province were collected.The chi-square test and non-parametric test were used to analyze the demographic and disease characteristics of COPD inpatients in different CCI groups,multiple linear regression was used to analyze the impact of CCI on the length of stay and cost of hospitalization,and Poisson regression was used to analyze the impact of CCI on in-hospital death.Results:The marital status,age,whether to be operated,whether to be transferred to another department,wards of admission to hospital and the number of hospitalizations had significant effects on CCI(P<0.05).Patients with CCI≥2 had longer hospitalization time,more hospitalization expenses and higher in-hospital mortality than those with CCI of 0-1.After controlling for statistically significant variables in univariate analysis,CCI was still the factor affecting the hospitalization time,hospitalization expenses and in-hospital death of COPD patients.High CCI was associated with poor prognosis(P<0.05).Conclusion:CCI is significantly correlated with length of stay,cost of hospitalization and in-hospital death of COPD patients.It is recommended to strengthen the screening of COPD patients and intensify the chronic disease management of COPD patients in grassroots medical institutions to reduce the burden of COPD and its comorbidities.

关 键 词：慢性阻塞性肺疾病 Charlson合并症指数 住院时间 住院费用 院内死亡 

分 类 号：R197.3[医药卫生—卫生事业管理]