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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 10884 patients with cerebral infarction

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【作者】 程先先; 李彬; 吴学森;

【Author】 CHENG Xianxian;LI Bin;WU Xuesen;School of Public Health, Bengbu Medical College;

【通讯作者】 吴学森;

【机构】 蚌埠医学院公共卫生学院; 蚌埠医学院第一附属医院;

【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10 884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14.00d;次均住院费用为24 387.88元,中位数为19 075.68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。

【Abstract】 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 10 884 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 24 387.88 yuan, with a median of 19 075.68 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.

【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)
  • 【分类号】R197.32;R743.33
  • 【下载频次】71
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