重症肺炎患者住院医疗费用的特征分析

Analysis of Inpatients' Medical Costs with Severe Pneumonia in Chengdu City

目的探讨重症肺炎与非重症肺炎患者住院医疗费用的差异,合理制定疾病诊断相关分类系统(DRGs)提供依据。方法将25例重症肺炎患者住院医疗费用与247例非重症肺炎患者作对照比较。结果重症肺炎患者住院费用的中位数为3941.62元,非重症肺炎患者为2860.07元(u=2.433,P=0.015),差别显著。重症肺炎患者与非重症肺炎患者药品费用以及诊疗费用的中位数差异均显著(P<0.05)。其他项目医疗费用的差别无统计学意义(P>0.05)。结论抗感染治疗是肺炎治疗的最主要环节,选择广谱的强力抗菌药物,足量、联合用药是重症肺炎的治疗原则之一,故与非重症肺炎患者的住院医疗费用存在明显差别。在制定疾病诊断相关分类系统(DRGs)时,应根据肺炎病例分型的不同特点,分别制定相应标准。

Objective In order to provide evidence for the construction of diagnosis related groups system （DRGs） through identifying the difference of medical costs between inpatients with severe pneumonia and those with non- severe pneumonia. Methods 25 inpatients＇ medical costs with severe pneumonia were compared with that of 247 with non - severe pneumonia in Chengdu. Results The median medical costs of inpatients with severe pneu- monia （3941.62 RMB） was significantly higher than that （2860.07 RMB） of inpatients with non- severe pneumonia （ u = 2.433, P = 0.015）. Sig- nificant differences existed between two groups in both median drug costs and median diagnosis and treatment costs （P 〈 0.05）. There were no signif- icant difference of other medical costs between them （ P 〉 0.05）. Conclusions Anti - infection therapy is the most important treatment of pneumonia. The principle of treatment for severe pneumonia is the selection of strong antibiotics with broad - spectrum, sufficient dosage and properly combined use of antibiotics, which could result in the obvious difference of medical costs between inpatients with severe pneumonia and those with non - severe pneu- monia. The different standards should be made according to the typing of pneumonia when DRGs is constructed.