基于临床路径管理的糖尿病住院患者医疗费用影响因素分析

Analysis of the Influential Factors of Diabetes Hospitalization Fees on the Clinical Pathway Conditions

目的:通过对实施临床路径的II型糖尿病住院患者医疗费用的相关因素进行分析,研究II型糖尿病住院患者医疗费用的影响因素并提出相关建议,为II型糖尿病住院患者医疗费用管理提供依据。方法:对某三甲医院778例第一诊断为II型糖尿病的患者的费用进行收集和整理,并采用广义线性模型进行影响因素分析。结果:II型糖尿病患者住院费用的影响因素为性别、医保类型、高血压、冠心病、脑部供血不足、呼吸系统疾病、腰椎间盘突出症、糖尿病肾病、糖尿病神经并发症、手术、住院天数和住院次数。影响因素的子类别分析结果为:能使住院费用增加的因素为男性、住院天数长和住院次数多;能使住院费用降低的因素为无手术和无腰椎间盘突出症、糖尿病神经并发症、糖尿病肾病等并发症。结论:尽管实施了标准化规范化的临床路径,住院费用仍受到许多因素的影响,需要进一步采取措施促使糖尿病的住院费用更加稳定和合理。

Objective： Through the analysis on the clinical pathway type II diabetes with the various factors associated with expenses in diabetes, pointing out influencing factors of the total cost of, in order to take corresponding measures to achieve more scientific and standardization medical behavior, guarantee the clinical pathway can achieve good quality and medical service quality under the most rational total cost. Methods： Analyzing 778 patients＇ costs indicators from a three level of first-class hospital whose first diagnosis is type II diabetes, using generalized linear model. Results： The influence factors of Type II diabetes＇ hospitalization fees are sex, medical insurance type, high blood pressure, coronary heart disease, brain VBI, respiratory system disease, prolapse of lumbar intervertebral disc, diabetic nephropathy, diabetic nerve complications, operation, be in hospital days in hospital and the times. Among the influential factors of hospitalization fees in type II diabetes, the factors to prompt hospital expenses are men, long hospital stay and more hospitalization number; The factors to reduce hospitalization fees are no surgery and without prolapse of lumbar intervertebral disc, diabetic nephropathy, nerve complications and so on. Conclusion： Although implemented a standardized standardized clinical pathway, hospital expenses still influenced by many factors, need to take further measures to make the hospitalization fees more Stable and reasonable.