后疫情时代中南地区脑卒中患者经济负担及影响因素研究

doi:10.5246/jcps.2022.07.048

摘要/Abstract

摘要：

疾病经济负担是患者疾病负担的主体, 针对目前出现的多种疾病类型, 专家学者们从不同的角度做了多方面的研究。本文主要通过研究湖南地区脑卒中患者产生住院费用的基本情况, 研究分析影响脑卒中患者住院费用的因素。通过回顾性随机抽取2019–2021年湖南省多家医院出院诊断ICD-10编码为I60～I64的患者的病案首页资料7270份, 分析患者住院费用情况及影响因素, 采用单因素分析法剔除无关因素, 并对有效因素进行多元线性回归分析。研究显示, 患者医药费用逐年上升, 其中药品费在患者住院费用中的占比高。住院费用总效应因素排名依次为: 住院天数、机构级别、疾病分型、性别、参保类型、年龄。脑卒中患者的负担严重, 建议采取加强对药物的科学合理使用、提升医疗技术、服务水平和做好疾病的早期筛查预防工作, 实现分级诊疗制度, 发挥社区医院的积极作用, 合理使用医疗资源; 制定科学合理的诊疗方案、缩短住院天数、有效控费、加强宣传教育、形成健康良好的生活习惯、缩短住院天数等措施控制医疗费用不合理增长, 减少脑卒中患者的负担。

关键词: 脑卒中, 住院费用, 影响因素

Abstract:

The economic burden of disease is the main burden of disease for patients, and experts and scholars have done various studies from different perspectives on various types of diseases. In the present study, we focused on the basic situation of hospitalization cost of stroke patients in Hunan Province and analyzed the factors affecting the hospitalization cost of stroke patients. A retrospective random sample of 7270-case home data of patients discharged from several hospitals in Hunan Province with diagnoses of ICD-10 codes I60 to I64 from 2019 to 2021 was used to analyze the patient’s hospitalization costs and the influencing factors. The univariate analysis was used to eliminate irrelevant factors, and multiple linear regression analysis was performed on the effective factors. Patients’ medical costs are increasing year by year, with drug costs accounting for a high proportion of patients’ hospitalization costs. The ranking of the total effect factors of hospitalization costs was as follows: the number of days of hospitalization, the level of the institution, the disease subtype, gender, the type of participation, and age. It was recommended to strengthen the scientific and rational use of drugs, improve medical technology and service level, do a good job in early screening and prevention of diseases, realize the hierarchical diagnosis and treatment system, play an active role in community hospitals, use medical resources rationally, develop scientific and rational treatment plans, shorten the number of days of hospitalization, control costs effectively, strengthen publicity and education, and form healthy and good living habits to shorten the number of days of hospitalization. The number of days of hospitalization should be shortened.

Key words: Stroke, Hospitalization costs, Influencing factors

Supporting:

彭词艳, 陈景, 李斯妮, 李健和, 彭六保. 后疫情时代中南地区脑卒中患者经济负担及影响因素研究[J]. 中国药学(英文版), 2022, 31(7): 545-555.

Ciyan Peng, Jing Chen, Sini Li, Jianhe Li, Liubao Peng. Study of the economic burden and influencing factors on stroke patients in Central China in the post-epidemic era[J]. Journal of Chinese Pharmaceutical Sciences, 2022, 31(7): 545-555.

图/表 10

Table 1. Basic hospitalization of stroke patients.

Table 2. Hospitalization costs for different demographic sociological characteristics.

Table 3. Basic information of stroke patients at different institutional levels.

Table 4. Basic information on the per capita hospitalization cost of stroke patients in different medical institutions.

Table 5. Basic hospitalization information of stroke patients with different disease types.

Table 6. Basic information of stroke patients with different insured types.

Table 7. Univariate analysis results of hospitalization costs.

Table 8. Spearman grade correlation analysis of age and hospitalization cost.

Table 9. Assignment of influencing factors.

Table 10. Multiple linear regression analysis of each variable and hospitalization cost.

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