2015—2019年山西省糖尿病住院病例统计及住院费用影响因素分析  

Statistics of hospitalized cases of diabetes in Shanxi from 2015 to 2019 and analysis of affecting factors of hospitalization costs

作　　者：白洁 韩颖 宋雲麟 BAI Jie;HAN Ying;SONG Yun-lin(School of Management,Shanxi Medical University,Shanxi,Taiyuan,Shanxi,030001,China)

机构地区：[1]山西医科大学管理学院,山西太原030001

出　　处：《现代预防医学》2023年第4期604-610,共7页Modern Preventive Medicine

基　　金：山西省软科学研究一般项目(2018041036-4)。

摘　　要：目的了解山西省糖尿病患者住院状况及疾病流行特征,探讨住院费用的影响因素,为加强住院费用的控制管理和患者的健康管理提供依据。方法收集样本地区2015—2019年77933例糖尿病患者住院情况,使用结构方程模型分析住院费用的影响因素。结果糖尿病患者住院人次逐年增加,男性增长率高于女性;60~69岁的患者最多,发病年龄发生后移;平均住院天数为10.64天,住院天数呈缩短态势;手术患者、并发症患者不断增加;市、区、县级机构就诊患者总体呈上升趋势,就诊机构级别发生下移。平均住院费用为7855.95元,检查费(36.01%)、药品费(35.68%)占比较大。平均住院费用、药品费、床位费呈下降趋势;治疗费、其他费波动上升;检查费呈下降趋势(趋势检验P值均<0.001)。结构方程模型结果显示影响住院费用的因素由大到小为住院天数、性别、机构级别、有无并发症、是否手术、年龄。结论我国糖尿病管理取得了一些成绩,但疾病负担仍较严重,应加强对检查费和药品费的监管、缩短住院天数、以基层为依托,开展高危人群健康教育和筛查,加强糖尿病预防工作。Objective To understand the hospitalization status and epidemic characteristics of diabetes patients in Shanxi Province,and to analyse the affecting factors of hospitalization costs,so as to strengthen the control of hospitalization costs management and provide basis for health management of patients.Methods The hospitalization conditions of 77933 diabetes patients in the sample area from 2015 to 2019 were collected,and the factors affecting hospitalization costs were analyzed using structural equation model.Results The Diabetic patients hospitalized person-time increases year by year,and the growth rate of men is higher than that of women;The patients aged 60-69 years were the most,and the age of onset shifted backward;The mean hospital stay was 10.64 days,and the length of stay was decreasing;The number of patients with surgery and complications is adding;The number of patients in city,district and county-level institutions showed an overall upward trend,and the level of medical institutions shifted downward.The average hospitalization cost was 7855.95 yuan,and the examination fee(36.01%)and drug fee(35.68%)accounted for a large proportion.The average hospitalization expenses,drug expenses and bed expenses showed a downward trend;The treatment fee and other fees fluctuated;The inspection fee showed a downward trend(P values of trend test were all<0.001).The results of the structural equation model showed that the factors influencing the hospitalization expenses were the length of hospitalization,gender,institution level,whether there were complications,whether there was surgery or not,and age.Conclusion Some achievements have been made in the management of diabetes in China,but the disease burden is still serious.It is necessary to strengthen the supervision of examination fees and drug fees,shorten the hospitalization days,rely on the grass-roots level,carry out health education and screening for high-risk groups,and strengthen the prevention of diabetes.

关 键 词：糖尿病 流行特征 住院费用 影响因素 预防 

分 类 号：R197.1[医药卫生—卫生事业管理]