糖尿病并发下肢周围神经血管病变住院患者的非手术治疗相关费用的调查

Investigation on the costs of non-operative treatment for the diabetic patients with vascular lesions of lower extremity peripheral nerve

目的通过糖尿病并发下肢周围神经血管病变患者非手术治疗的相关费用的调查,探索在一级医院对该病治疗的最好疗效和最低费用。方法分析某一级医院2005—2011年500例住院并发下肢周围神经血管病变糖尿病患者的非手术治疗相关费用。结果①平均每人住院费4 555.37元,其各项平均费用为西药1 669.38元、中药1 313.41元、检验800.78元、治疗193.69元、床位167.98元、检查198.72元、护理68.32元、诊查63.29元及材料79.87元。②病程长短、并发症严重程度等均与患者非手术治疗所花费用成正比:病程5～10 a以及>10 a的患者所花费的西药费、治疗费、床位费以及总费用均高于病程<5 a的患者;病程>10年的患者所花费的中草药费、诊查费和护理费高于病程<5 a以及5～10 a的患者。2种和3种及以上并发症的患者所花费的西药费、中成药费、检验费、检查费、床位费、诊查费以及总费用均高于无并发症或只有1种并发症的患者。病理二期的患者所花费的西药费、检查费、治疗费、床位费、诊查费以及总费用均高于病理一期的患者。3种和3种以上并发症及动脉病变的患者所花费的检查费和治疗费高于1及2种动脉病变的患者。结论某一级医院采用中西结合特色治疗糖尿病并发下肢周围神经血管病,可使该病获得了最佳治疗效果和最少不良反应,且住院费用最低,为国家、医保、个人节减医药费用开支探索出新的途径。

[Objective]To analyze the costs of non-operative treatment for the diabetic patients with vascular lesions of lower extremity peripheral nerve,and explore the treatment for these diabetic patients in hospitals of lower level with the best efficacy and minimum costs.[Methods]The non-operative treatment costs of hospitalized diabetic patients in a first-level hospital with vascular lesions of lower extremity peripheral nerve were analyzed from 2005-2011.[Results] ①The average hospitalized costs was 4 555.37 yuan per capita,including 1669.38 yuan of western medicine costs,1 313.41 yuan of Chinese traditional medicine costs,800.78 yuan of test costs,193.69 yuan of treatment costs,167.98 yuan of bed costs,198.72 yuan of examination costs,68.32 yuan of nursing care costs,63.29 yuan of diagnosis costs and 79.87 yuan of material costs.② Duration of disease,severity of complications,etc were positively related with the costs of non-operative treatment： western medicine costs,treatment costs,bed costs and total costs of patients with course of disease 5-10 a and 10 a were higher than those of patients with course of disease 5 a;traditional medicine costs,diagnosis costs and nursing care costs of patients with course of disease 10 a were higher than those of patients with course of disease5 a and 5-10 a;the western medicine costs,traditional medicine costs,test costs,examination costs,bed costs and diagnosis costs and total costs of patients with 2 and above 2 complications were higher than those of patients without complication or only 1 complication;the total costs,western medicine costs,test costs,treatment costs,diagnosis costs and the bed costs of patients with pathological II period were higher than those of patients with pathological I period;the tests costs and treatment costs of patients with 3 or above 3 complications and artery lesions were higher than those of patients with 1 or 2 artery lesions.[Conclusion]The non-operative treatment of traditional Chinese medicine with Western medicine adopted by a first-level hospital can obtain not only the best efficacy and least side effects,but also the lowest hospital charges.It has explored a new way for saving medical expenses of country,health insurance and individual.