急性胰腺炎患者住院费用及影响因素分析

Analysis on the Hospitalization Expenses and Influencing Factors in Patients with Acute Pancreatitis

目的分析急性胰腺炎患者住院费用构成及主要影响因素,为合理控制医疗费用提供依据。方法收集河南省某三级综合医院2015年急性胰腺炎住院患者病案首页数据,回顾性分析住院费用,并采用多重回归分析方法探讨与患者住院费用有关的因素。结果758例急性胰腺炎患者中位住院费用25104.57元。不同医疗付款方式、年龄、入院途径、住院次数、住院时间、出入院诊断符合情况、伴随疾病、是否重症、是否手术患者的住院总费用比较,差异有统计学意义(P<0.05)。费用构成中药费最高,占60%以上,重症患者各项费用高于轻症患者(P<0.05)。影响住院费用的因素有医疗付款方式、入院途径、住院次数、伴随疾病、是否重症、是否手术、住院时间(P<0.05)。结论急性胰腺炎患者住院费用受多种因素综合影响,应合理调整医疗卫生机构收费结构,通过控制并发症,缩短住院时间,降低药品费用等方法降低患者住院费用。

Objective To analyze the hospitalization expenses and influencing factors of patients with acute pancreatitis,so as to provide evidence on the reasonable control of hospitalization expenses.Methods Patients with acute pancreatitis admitted to tertiary hospital in Henan in 2015 were investigated according to the front pages of medical records.Hospitalization expenses were analyzed retrospectively.Multivariate analysis was used to explore the factors related to hospitalization expenses.Results The median hospitalization expense of 758 patients with acute pancreatitis was 25104.57 yuan.There were statistical differences in total expenses of hospitalization of patients with different medical payment,age,route of admission,hospitalization times,length of stay,coincidence between admitting diagnosis and discharge diagnosis,associated diseases,whether severe,whether surgery(P<0.05).Among the total expenses,expense for drug was the highest,accounting for more than 60%.The expenses in severe patients were higher than those in mild patients(P<0.05).The medical payment,route of admission,hospitalization times,associated diseases,whether severe,whether surgery and length of stay were the influencing factors of hospitalization expenses(P<0.05).Conclusion The hospitalization expenses of patients with acute pancreatitis are influenced by many factors.The charge structure of medical and health institutions should be adjusted reasonably.The expenses of hospitalization can be reduced by controlling complications,shortening hospitalization time and reducing drug expense.