10884例脑梗死患者住院费用影响因素的通径分析  

The path analysis of hospitalization costs and influencing factors in 10 884 patients with cerebral infarction

作　　者：程先先 李彬[2] 吴学森 CHENG Xianxian;LI Bin;WU Xuesen(School of Public Health,Bengbu Medical College,Bengbu 233030,China;The First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China)

机构地区：[1]蚌埠医学院公共卫生学院,安徽蚌埠233030 [2]蚌埠医学院第一附属医院,安徽蚌埠233004

出　　处：《现代医院》2023年第1期87-90,93,共5页Modern Hospitals

基　　金：蚌埠医学院研究生科研创新项目(Byycxz21050);蚌埠医学院慢性非传染性疾病预防与控制创新团队(BYKC201901)。

摘　　要：目的通过分析安徽省某三甲综合医院脑梗死患者住院费用,探究其影响因素,为减轻患者疾病经济负担提供科学依据。方法收集样本医院2015—2019年的10884例脑梗死患者病案首页资料,对脑梗死患者基本情况及费用构成情况进行描述性分析,并采用多元回归分析拟合通径分析模型的方法,研究脑梗死患者住院费用的影响因素。结果脑梗死患者次均住院日为15.49 d,中位数为14.00 d;次均住院费用为24387.88元,中位数为19075.68元。通径分析研究结果显示,住院日是住院费用的主要影响因素,农民、医保、入院途径、出院转归、是否手术、伴随症个数、出院时间、药占比在直接影响住院费用的同时,还通过住院日对住院费用存在间接影响,而性别、无业/离退休、危重对住院费用仅存在直接作用。结论多种因素影响着脑梗死患者住院费用,有效缩短住院日,加强可控因素的控制同时加强对医院的管理,最大可能地减轻患者医疗负担。Objective By analyzing the hospitalization cost of cerebral infarction patients in a third grade a general hospital in Anhui Province,the influencing factors were explored to provide scientific basis for reducing the economic burden of the patients.Methods The first page data of medical records of 10884 patients with cerebral infarction in the sample hospital from 2015 to 2019 were collected,and the basic information and cost composition of cerebral infarction patients were descriptive analyzed.Multiple regression analysis was used to fit the path analysis model to study the influencing factors of hospitalization cost of cerebral infarction patients.Results The average length of hospital stay of cerebral infarction patients was 15.49 days,with a median of 14.00 days.The average hospitalization cost was 24387.88 yuan,with a median of 19075.68 yuan.Size analysis Results show that such confinement is the main factors affecting hospitalization expenses,farmers,health care,hospital,hospital outcome,whether surgery,with the number,discharge time,medicine accounted for at the same time,in a direct impact on medical expenses is also through such confinement on the indirect effects exist in hospitalization expenses,and gender,unemployed,retired,critical effect on hospitalization expenses exists only directly.Conclusion A variety of factors affect the hospitalization costs of patients with cerebral infarction,effectively shorten the hospitalization days,strengthen the control of controllable factors and strengthen the management of hospitals,so as to reduce the medical burden of patients to the greatest extent possible.

关 键 词：脑梗死 住院费用 影响因素 通径分析 

分 类 号：R197.3[医药卫生—卫生事业管理]