某三甲医院2017-2021年脑梗死患者住院费用分析  

Analysis on Hospitalization Costs of Cerebral Infarction Patients in a Three A And Tertiary Hospital from 2017 to 2021

作　　者：王仲 包爱枝 Wang Zhong;Bao Aizhi(Medical Records Room,The First People's Hospital of Wuhu City,Wuhu 241000,Anhui Province,China;不详)

机构地区：[1]芜湖市第一人民医院,安徽省芜湖市241000

出　　处：《中国病案》2024年第12期58-63,共6页Chinese Medical Record

摘　　要：目的分析某三甲医院脑梗死患者住院费用的变化趋势和影响因素,为医保、财务等部门合理控制医疗费用提出依据和建议。方法由某院住院病案首页资料库中提取2017年1月1日-2021年12月31日神经内科主要诊断为脑梗死住院患者共计5839例的住院病案首页数据作为研究对象。采用Excel和SPSS对收集数据进行描述统计分析,涉及变量包括年度、性别、年龄、住院天数、是否手术、入院情况和出院情况,进行方差分析、t检验和多元线性回归分析。结果共计5839例有效数据纳入研究。脑梗死5年住院患者人数与住院费用逐年增加,男性患者中位住院费用7745.55元高于女性患者的6858.73元;入院情况为急症患者中位住院费用8043.77元、危症患者费用8032.75元,高于一般患者的7312.67元;出院情况为未愈、死亡和其他的患者中位住院费用分别是7346.58元、7402.68元和7687.15元,较治愈和好转患者的花费6235.27元和6489.73元有所增加;手术患者中位住院费用为15834.32元,是非手术患者中位住院费用的近3倍。所选变量分组均P<0.05,差异具有统计学意义。经统计分析后,年度、男性性别、住院天数≥10天、出院情况未愈、年龄、手术这几项因素对住院费用影响R2=0.410,F=581.065,P<0.05,差异具有统计学意义。并且是影响脑梗死住院费用的独立影响因素,P<0.05,其中住院天数对费用的影响最为重要,回归系数最大,P<0.05,差异具有统计学意义。结论年度越晚、男性患者、住院天数≥10天较<10天患者、手术较非手术患者其花费更高,病例数也较多。应对影响脑梗死患者住院费用的具有统计学意义的因素加以合理管理和监控,一体化、立体化整合住院流程,缩短住院天数,尽早防治基础病、并发症,针对性引入治疗评价体系,降低源头成本费用,加强宣教与研究等采取有效手段予以干涉和改善。Objectives To analyze he changing trend and influencing factors of hospitalization costs of cerebral infarction patients in a Three A and Tertiary Hospital based on the front-page data,and the basis and suggestions were put forward for medical insurance,finance and other departments to control medical costs.Methods The front page data of cerebral infarction inpatients in the Department of Neurology from January 1st,2017 to December 31st,2021 were extracted from the database of medical records(Jinchuang medical record home page software)and analyzed.Excel and spss22.0 were used to carry out descriptive statistical analysis of the collected data,including year,gender,age,length of stay,whether operation(based on the International Classification of Diseases Operation Code Library National Edition 3.0),admission(emergency,critical,general)and discharge(cure,improvement,uncured,other),and variance analysis,t test and multiple linear regression analysis were performed.Results A total of 6017 cases of cerebral infarction were extracted,of which 5839 valid data were eventually included in the analysis.The number and cost of cerebral infarction inpatients increased year by year in the past 5 years.The median cost of male patients was 7745.55 yuan,which was more than that of female patients(6858.73 yuan).The median cost of emergency patients was 8043.77 yuan,and the cost of critical patients was 8032.75 yuan,which was significantly more than that of general patients(7312.67 yuan).The median hospitalization cost of patients with uncured,dead and other conditions was 7346.58 yuan,7402.68 yuan and 7687.15 yuan,respectively,which increased compared with the cost of cured and improved patients(6235.27yuan and 6489.73 yuan).The median cost of surgical patients was 15834.32 yuan,nearly three times that of non-surgical patients.After statistical analysis,the year,gender(male),hospitalization days(≥10 d),discharge(uncured),age these factors on the cost of hospitalization were statistically significant,all significant(R~2=0.410,F=

关 键 词：脑梗死 影响因素 住院费用 

分 类 号：R197.3[医药卫生—卫生事业管理] R743.33[医药卫生—公共卫生与预防医学]