脑卒中患者住院费用影响因素分析

Effect factors analysis of hospitalization expenses of stroke inpatients

目的 分析脑卒中住院病人住院费用的相关影响因素,为控制脑卒中住院费用提供依据方法 连续性登记我院2007-09-2008-03住院的脑卒中患者495例,收集可能与患者住院费用有关的因素,如性别、年龄、文化程度、付费方式、入院时NIHSS评分、卒中类型、住院天数、收入情况等,并利用多元线性逐步回归分析法筛选影响住院费用的因素结果 经单因素分析发现,性别、文化程度、付费方式、入院时NIHSS评分、住院天数、收入情况等对脑卒中患者住院费用可能有影响,将这些因素引入多因素模型进一步研究,发现影响脑卒中患者住院费用的因素依次为住院天数、入院NIHSS评分、收入情况（P〈0.05）结论 减少住院日,规范用药可以降低脑卒中患者的住院费用.因此,提高医院的医疗水平和管理水平,强化临床路径的实施和管理,根据循证医学的方法用药,规范诊断和治疗,是缩短住院天数减少住院费用的有效措施,进而可以保证脑卒中患者得到经济有效的医疗服务.

Objective To provide references to control the cost for stroke inpatients by analyzing pertinent factors of hospitalization expenses of stroke inpatients. Methods The study subjects were 495 stroke patients who were hospitalized in General Hospital of Yangquan Coal Industry from Sep 2007 to Mar 2008. Some information about these patients were continuously recorded, and some possible factors affecting their medical cost were collected such as sex, age, level of education, manner of payment, NIHSS grade on admission, days of hospitalization and income. These factors were analyzed and screened out using the method of stepwise multiple regression model. Results It is found by single factor analysis that age, level of education, manner of payment, NIHSS grade on admission, days of hospitalization and income were probably the main factors which affected the expense of stroke patients. After further study using the method of stepwise multiple regression model, it is found that the factors affecting inpatient expense were the days of hospitalization, NIHSS grade on admission and income according to priority （P〈0. 05）. Conclusion Decreasing unnecessary days of hospitalization and avoiding the inappropriate use of medication can reduce the hospitalization expenses of stroke inpatients. It would be desirable to promote the hospital＇s medical and management level, strengthen the implementation and management of clinical pathways, use medicine according the rule of evidence-based medicine, and carry out standard diagnosis and treatment, while ensuring that stroke patients could receive cost-effective medical selvlces.