康复科住院患者功能独立性测量与住院费用和时间的关系  

The relationship between the admission FIM score and hospital costs and length of stay in neurorehabilitation inpatients

作　　者：邱纪方[1] 李建华[1] 梁小平[2] 林秀英[1] 

机构地区：[1]浙江省人民医院康复医学科,杭州310014 [2]台州医院理疗科

出　　处：《中华物理医学与康复杂志》2002年第7期391-395,共5页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的　探讨康复科神经伤病患者住院费用的特点、入院功能独立性测量 (FunctionalIndepen denceMeasure ,FIM )及其分量表分与住院费用和时间的关系。方法　回顾调查了 1994～ 1998年在康复科住院的记录完整的 64例神经伤病患者住院费用与FIM资料 ,并进行统计学分析。结果　住院患者人均住院时间为 98.77± 99.15d ;人均住院总费用为 2 2 5 79.61± 2 170 2 .2 4元 ;入院FIM、自我照料、括约肌控制、转移、运动分量表分与住院时间均呈负相关 (r =-0 .2 5 3～ -0 .3 14 ,P <0 .0 5 ) ,入院FIM与床位费、治疗费、西药费、总费用呈负相关 (r =-0 .2 77～ -0 .3 5 3 ;P <0 .0 1～ 0 .0 5 ) ;住院时间与和各项住院费用间均有较好的正相关 (r =0 .40 4～ 0 .82 7,P <0 .0 1)。在脑卒中、外伤性脑损害、脊髓损伤三个疾病组中 ,脑卒中组入院FIM分与住院时间、治疗费、总费用呈显著负相关 (r =-0 .3 81～ -0 .44 4,P <0 .0 5 ) ,三组住院时间与床位费、治疗费、西药费均呈良好正相关 (r =0 .5 40～ 0 .878,P <0 .0 1～ 0 .0 5 )。结论　在康复科住院患者费用中 ,西药费最高 ,其次为治疗费 ;各项住院费用随住院时间延长而增高 ;患者的住院费用与入院时残疾程度有关 ;入院FIM分、自我照料、括约肌控制。Objective To investigate the characteristics of the hospital costs in neurorehabilitation inpatients,the relationships of the Functional Independence Measure(FIM) and its subscale scores with hospital costs of major items and length of stay(LOS). Methods A retrospective study was carried out with 64 neurorehabilitation inpatients.The hospital costs,LOS,admission FIM and FIM subscale scores were calculated for statistical analysis. Results The average length of stay for each patient was 98.77±99.15 day.The average hospital costs was 22 579.61 ±21 702.24 yuan RMB for each patient. The admission FIM total scores,selfcare,sphincter control,transfer, motor subscale scores were negatively correlated to length of stay( r =-0.253～-0.314, P <0.05).Admission FIM score was negatively correlated to bed fee,fee of therapy ,fee of western medication and total fee( r = -0.277 ～-0.353, P <0.01～ 0.05 ).There were significantly positive relationships between LOS and all items of hospital costs( r =0.404～0.827, P < 0.01 ).Among the three impairment groups,there were significantly negative relationships between admission FIM scores and LOS, fee of therapy ,total hospital cost in the group of stroke patients( r =-0.381～-0.444, P < 0.05 ).LOS was positively correlated to bed fee,fee of therapy,fee of western medication in all of the three groups( r =0.540～0.878, P <0.01). Conclusion The cost of western medication is the highest among all kinds of hospital costs with the cost of rehabilitation therapy ranking the second in neurorehabilitation inpatients. There is good positive relationship between hospital costs and LOS.Hospital costs are related to the severity of disability at the time of admission.Admission FIM total scores,selfcare,sphincter control,transfer,motor subscale scores may be able to predict the hospital costs and LOS in neurorehabilitation inpatients.

关 键 词：康复科 住院患者 功能独立性测量 住院费用 住院时间 神经康复 

分 类 号：R493[医药卫生—康复医学]