78例极低出生体重儿住院费用调查及影响因素分析

Investigation on the Hospitalization Expenses of 78 Cases of Very Low Birth Weight Infants and Relevant Influencing Factors

目的了解极低出生体重儿(VLBWI)住院费用情况及其影响因素。方法通过住院HIS系统中提取VLBWI住院病例资料,分析VLBWI患儿住院费用的构成比,再根据人均住院总费用产生的情况将VLBWI患儿分为高费用组及低费用组,分析两组VLBWI住院费用差别,并进一步研究临床因素对VLBWI住院费用的影响。结果影响VLBWI住院费用前5位的项目分别为:呼吸机、氧气及监护费;药费;检查及化验费;材料费;治疗费。高费用组在住院天数、人均住院总费用、呼吸机及氧气费用、药费、检查及化验费、治疗费、以及材料费明显高于低费用组。高费用组胎龄、体重明显低于低费用组,而新生儿呼吸窘迫综合症(RDS)、晚发性败血症发生率上明显高于低费用组。结论胎龄、体重低,且住院过程中并发RDS、晚发型败血症的发生率高,可能是高费用组VLBWI住院费用高于低费用组的原因所在。

Objectives To investigate the hospitalization expenses of 78 very low birth weight infants （VLBWI） and relevant influencing factors. Methods To collect VLBWI inpatient data through HIS system in hospital and analyze the constitute ratio of hospitalization expenses of VLBWI. 78 VLBWI infants were divided into high cost group and the low cost group according to the average total hospitalization cost, then analyzed the differences of hospitalization cost between the two groups of VLBWI, as well as and further studied the effect of clinical factors on VLBWI hospitalization expenses. Results The top five projects influenced the hospitalization cost of VLBWI included： ventilator, oxygen and custody fee; drugs; check and test fees; material cost; treatment fee. High costs group in the days of hospitalization, total cost per patient, ventilator and oxygen cost, medicine, inspection and examination fees, treatment costs, and the cost of materials was significantly higher than that of the low cost group. Gestational age, body weight of VLBWI in high cost group was significantly lower than in low cost group, and neonatal respiratory distress syndrome （RDS）, the incidence of late sepsis was significantly higher than the low cost group. Conclusions Lower gestational age, birth weight, higher incidence of RDS and late onset of sepsis might be resulted in higher hospitalization costs in high costs group of VLBWI.