摘要
目的 探讨老年慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者住院费用的构成及其影响因素.方法 从病案系统内提取南通市某三甲医院 2020 年 1月—2022 年 12 月出院的 2 176 例 65 岁以上 COPD 患者的病案首页资料,包含年龄、性别、住院天数、付款方式、入院途径、是否手术、转归、入院年份等.采用单因素分析和多元线性回归分析对住院费用的影响.结果 2 176 例老年 COPD 患者中,男性 1 922 例(88.32%),女性 254 例(11.67%),平均年龄 77(71,82)岁,平均住院费用 18 264.25(10 293.60,40 014.66)元.人均住院费用构成中占比前 3 位的费用类别为西药类、诊断类、耗材类.影响患者住院费用的单因素为年龄、住院天数、转归、付款方式、入院途径、是否手术以及入院年份,差异有统计学意义(P＜0.05).多元线性回归分析显示,年龄、住院天数、转归、入院途径、是否手术、入院年份均在不同程度上影响人均住院总费用.结论 老年COPD患者的住院费用与年龄、住院天数、转归、入院途径、是否手术、入院年份密切相关.西药类、诊断类、耗材类为住院费用结构的前3位,医疗机构需要不断优化住院费用结构,规范临床路径,缩短住院时间,降低疾病经济负担.
Abstract
Objective To investigate the composition and influencing factors of hospital expenses in senile chronic obstructive pulmonary disease(COPD)patients.Methods The homepage data of 2 176 COPD patients aged 65 and above who were discharged from a tertiary hospital in Nantong city from January 2020 to December 2022 from the medical record system were extracted,including age,gender,length of stay,payment method,admission route,whether surgery was performed,outcome,and year of admission.The effects of single factor anlysis and multiple linear regression on hospitalization costs were analyzed.Results Among 2 176 elderly COPD patients,there were 1 922 males(88.32%)and 254 females(11.67%),with an average age of 77(71,82)years and an average hospitalization cost of 18 264.25(10 293.60,40 014.66)yuan.The top three expense categories in the composition of hospitalization expenses were western medicine,diagnosis and consumables.The single factors influencing were age,length of stay,outcome,payment method,admission route,operation or not and year of admission,the differences were statistically significant(P<0.05).Multiple linear regression analysis showed that age,length of hospital stay,outcome,admission route,surgery,and year of admission all have varying degrees of impact on the per capita hospitalization total costs.Conclusion The hospitalization cost of elderly with COPD patients is closely related to age,hospitalization days,outcome,admission route,operation or not,and admission time.Western medicine,diagnostics and consumables are the top three categories of hospitalization cost structure.Medical institutions need to continuously optimize hospitalization cost structure,standardize clinical pathways,shorten hospitalization time and reduce disease economic burden.
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万方数据