【摘要】 目的:探讨三级单位卒中单元在降低医疗费用、实现医疗资源合理配置方面的作用效果。方法:建立三级单位卒中单元,包括急性卒中病房、康复中心和家庭护理单位。通过完备的专人随诊体系,对卒中病人提供卒中管理,随诊1年。于急性期、康复期、3个月末、6个月末和12个月末共进行5次评价,统计各阶段的医疗费用。结果:三级单位卒中单元内患者,脑出血及脑梗塞急性期例均住院费用分别为7547元和6078元,仅为全国同类省级医院平均住院费用的57.30%及59.30%;平均住院日分别为14日和11日,均较全国同类省级医院为短。脑卒中患者发病1年内例均疾病负担为15074元,其中,入院急性期费用占45.57%,康复期占21.86%,出院康复期及间接费用占32.57%。结论:三级单位卒中单元是治疗脑卒中的一种有效方法,能明显减少住院时间和医疗费用,将有限的医疗资源合理分配到疾病全程,有助于调整医疗费用的结构,实现医疗资源的合理配置。更多还原

【Abstract】 Stroke seriously influence people’s life and health with high morbidity, mortality and disability, and cause huge economic loss for individual, family and society. The paper described the economic burden of stroke patients in standardized tertiary stroke unit through the analysis of medical costs in the first year after stroke. The results showed that the average cost per patient stroke was 15 074 Yuan during 12 months (cost for acute stage was 45.57%, cost for rehabilitation was 21.86%, and indirect medical costs was 32.57%). In acute stage, the average costs per infarct and hemorrhagic patient stroke were 6078 and 7647 Yuan respectively, which were only 57.3% and 59.3% of average costs in China. Meanwhile, the average days of hospitalization for infarct and hemorrhagic patient stroke from 19~20 days decrease to 11~14 days. Standardized tertiary stroke unit may reduce cost and time for hospitalization in stroke patients, thus decrease economic burden of stroke disease. The study provides the important evidence for the superiority of standardized tertiary stroke unit in stroke treatment, and is in favor of optimizing the allocation of health resources.更多还原