2006～2015年糖尿病足病患者住院医疗费用调查

An investigation into the medical expenditures in the patients with diabetic foot ulcers from 2006 to 2015

目的调查2006～2015年糖尿病足患者住院医疗费用变化。方法采用全军统一研发的病历数据库,纳入2006～2015年解放军第306医院所有住院第一诊断为糖尿病足患者的病历首页数据,分析患者相关医疗费用信息。结果 10年期间共收治糖尿病足患者1962例,其中男性1201例,女性761例。各年度患者年龄中位数从70岁降至61岁,住院天数中位数由29 d降至17 d。最高日均药品费、日均检查费和日均床位护理费用中位数分别为649.5元、345.5元和114.7元,呈逐年上升趋势,最高日均治疗费中位数为191.2元,变化不显著。自费患者比例逐年下降,由42.2%(35/83)降至10%以下,新型农村合作医疗患者比例增高达18.1%(27/149),并且医疗总费用增高。结论 2006～2015年这10年间我院糖尿病足患者发病年龄年轻化,住院时间明显缩短,医疗费用增长显著,自费患者的比例逐年下降,新型农村合作医疗患者比例逐年上升。

Objective To investigate the changes in medical expenditures in the patients with diabetic foot ulcers treated during2006 to 2015. Methods The medical records of those first diagnosed as diabetic foot in Chinese PLA Hospital No. 306 from 2006 to2015 were retrieved from a self-developed database for the analysis of their medical expenditures. Results A total of 1962 patients（1201 males and 761 females） with diabetic foot were treated in this 10-year period,with the median age falling from 70 to 61 years and the median hospitalization from 29 to 17 days. An annual increase was observed in the highest average daily medication cost（median = RMB $ 649. 5）,the highest average daily examination fee（median = RMB $ 345. 5） and the highest average daily bed care cost（ median = RMB $ 114. 7） with a median of the highest daily average treatment cost being RMB $ 191. 2,which had no significant change. The proportion of self-funded patients decreased yearly from 42. 2%（35/83） to less than 10%,and the proportion of the patients covered by New Rural Cooperative Medical Care by 18. 1%（27/149）,and the total medical cost increased. Conclusion From2006 to 2015,the patients with diabetic foot became younger,with shorter hospital stay,increased medical cost,yearly decrease in the proportion of self-funded patients,and yearly increase in the proportion covered by New Rural Cooperative Medical Care.