摘要
目的 探索内蒙古糖尿病患者住院费用的影响因素,为合理控制医疗支出、减轻患者经济负担提供参考依据.方法 采用回顾性研究的方法收集2022年1月1日—12月31日7301例老年患者的住院信息,使用非参数检验对住院费用进行单因素分析,在此基础上对住院费用进行广义线性回归,结合上述结果构建随机森林模型,探讨影响住院费用的关键因素.结果 2022年内蒙古糖尿病患者次均住院费用中位数为5406.17元.从各类费用构成比看,药品费居于首位(25.66％),其次为化验费(21.40％).年龄、住院天数、糖尿病分类、并发症/合并症、转科、手术、医疗机构类别、医疗机构级别及医疗机构性质是住院费用的影响因素,其中住院天数、年龄、手术、医疗机构级别和类别是住院费用的关键影响因素.结论 糖尿病患者住院费用较高,其中药品费为首位.可从优化社区糖尿病管理、缩短住院时间、提升基层医疗能力,并通过医保政策引导患者合理就医,减轻疾病负担.
Abstract
Objectives This study aims to explore the factors influencing hospitalization costs for diabetic patients in Inner Mongolia and provide reference for reasonable control of medical expenditure and reduction of patients'economic burden.Methods A retrospective study method was used to collect hospitalization information of 7,301 elderly patients.The nonparametric test was used to conduct univariate analysis of hospitalization costs.On this basis,a generalized linear regression was performed on the hospitalization costs.Combined with the above results,a random forest model was constructed to explore the key factors affecting hospitalization costs.Results The median average hospitalization cost per visit for diabetes patients in Inner Mongolia was 5,406.17 yuan in 2022.Among the various cost components,drug costs accounted for the largest proportion(25.66％),followed by laboratory fees(21.40％).Age,length of hospital stays,diabetes classification,complications/comorbidities,department transfer,surgery,type of medical institution,level of medical institution,and nature of the medical institution were identified as factors influencing hospitalization costs.Among these,length of hospital stays,age,surgery,and the level and type of medical institution were key influencing factors.Conclusions Hospitalization costs for diabetic patients are relatively high.Strategies such as optimizing community diabetes management,reducing length of stay,enhancing primary healthcare capabilities,and guiding patients towards rational healthcare through insurance policies can help alleviate the economic burden of disease.
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