中国西部某市2型糖尿病及微血管并发症住院费用情况

Hospitalization expenses of type 2 diabetes and microvascular complications in a city of western China

目的描述T2DM及微血管并发症的入院特点及住院费用构成,分析住院费用的影响因素。方法收集4家综合医院1年出院第一诊断为T2DM的住院病历,构建一般线性模型(GLM)进行费用分析。结果收集病例1726例,分为4大类19个亚类,平均入院年龄60岁,住院时间中位数12 d,住院费用中位数7122元,医疗服务费用、诊断费用、西药费用分别占23%、22%、45%。GLM结果表明,住院时间对不同T2DM亚组的住院费用影响表现不同,与T2DM无并发症比较,住院时间对视网膜病变、多发神经病变的住院费用影响差别不大(β=21.7,97.4;P=0.67,0.02);而对肾小球硬化症、多发性微血管病变与伴有血糖控制不佳的影响则较大(β=172.7、240.9、163.5,P<0.01)。结论对不同入院年龄、住院时间、住院费用的T2DM并发症应进行分类管理。

Objective To investigatethe admission characteristics of type 2 diabetes （T2DM） and its microvascular complications, describe the components ofhospitalization expenses of those patients, and analyze the influencing factors for hospitalization expenses. Methods All hospitalized medical records with T2DM as the first diagnosis were collected from four general hospitals for 1 year. General linear model （GLM model） wasadopted to analyze the influence factors for the expenses. Results A total of 1726 medical records were collected and divided into 4 groups and 19 subgroups. The average admission age was 60 years, the median length of hospital stay was 12 days, the median hospitalization expenses was 7122 yuan, and the proportion of service, diagnostic, west-medicinecosts was 23%, 22%, and 45% respectively. GLM analysis showed that the influences of length of hospital stay on hospitalized expenses were different in each T2DM subgroups. Compared with T2DM without complications, length of hospital stay had little influence on hospitalization expenses in patients with retinopathy and polyneuropathy（β= 21.7,97.4; P = 0. 67, 0. 02）, but had significant effect on hospitalization expenses in patients with intracapillary glomerulone phrosis, multiple microvascular complication and poor glucose control （β= 172.7,240. 9,163.5;P〈0. 01）. Conclusion Classification management should be used in patients with different admission ages, different length of hospital stay, and different hospitalized expenses.