北京市某三级医院上消化道出血住院患者病因特征及治疗费用分析

Etiological characteristics and treatment costs of inpatients with upper gastrointestinal bleeding in an A tertiary hospital in Beijing

目的 探讨上消化道出血(UGIB)患者的病因特征,分析所承担的治疗费用及其影响因素。方法 从平谷区某医院信息管理系统中导出2016年10月至2021年9月UGIB住院患者基线资料、检查结果、治疗及住院时间等信息。并从医院收费系统调取患者住院费用、手术费、输血费、西药费、中成药费等相关治疗费用信息。采用描述性及非参数分析临床资料及治疗费用,采用多重线性回归分析治疗费用的相关因素。结果 共纳入1 022例UGIB住院患者,男性732例(71.62%),女性290例(28.38%),男女比例为2.52∶1;18~44岁209例,45~59岁244例,60岁及以上569例。不同性别的疾病年龄分布差异有统计学意义(P<0.01)。1 022例UGIB患者住院时间为14(10,17)d,治疗费用:检查费为2 755.0(1 988.0,4 575.3)元,手术费为1 870.0(1 380.0,2 603.0)元,输血费为1 546.0(0,2 773.3)元,西药费为9 746.5(8 765.5,11 527.3)元,中成药费为212.0(168.8,255.0)元,总费用为16 007.5(12 581.3,19 916.5)元。多重线性回归分析结果显示,年龄(β’=0.574)、合并高血压(β’=0.054)、合并冠心病(β’=0.064)、是否输血(β’=0.257)、是否胃癌(β’=0.047)以及住院时间(β’=0.230)为影响治疗费用的影响因素。结论 UGIB男性患者多于女性,不同年龄组病因存有差异,老年患者治疗费用较高,合并高血压、冠心病、输血、住院时间较长亦为高治疗费用的关键影响因素。

Objective To investigate the etiological characteristics of patients with upper gastrointestinal bleeding(UGIB)and to analyze the treatment costs and its influencing factors.Methods From October 2016 to September2021,the baseline data,examination results,treatment,and hospitalization time of UGIB inpatients were derived from the hospital information management system of a hospital in Pinggu District.And from the hospital charging system,the relevant treatment costs information such as hospitalization expenses,operation fees,blood transfusion fees,western medicine fees,and Chinese patent medicine fees was retrieved.Descriptive and nonparametric analyses were used to analyze clinical data and treatment costs,and multiple linear regression was used to analyze the related factors of treatment costs.Results A total of 1 022 UGIB inpatients were included,including 732 males(71.62%)and 290 females(28.38%),with a male-female ratio of 2.52∶1;209 patients aged 18-44 years old,244 patients aged 45-59 years old,569 patients aged 60 and years old.There was a statistically significant difference in the age distribution of disease among different genders(P<0.01).The hospitalization time of 1 022 UGIB patients was 14(10,17)days,and the treatment costs:the examination fee was 2 755.0(1 988.0,4 575.3)yuan,the operation fee was 1 870.0(1 380.0,2 603.0)yuan,the blood transfusion fee was 1 546.0(0,2 773.3)yuan,the western medicine fee was 9 746.5(8 765.5,11 527.3)yuan,the Chinese patent medicine fee was 212.0(168.8,255.0)yuan,and the total cost was 16 007.5(12 581.3,19 916.5)yuan.The results of multiple linear regression analysis showed that age(β’=0.574),hypertension(β’=0.054),coronary heart disease(β’=0.064),blood transfusion(β’=0.257),gastric cancer(β’=0.047),and the length of hospitalization time(β’=0.230)were the influencing factors of treatment costs.Conclusion Male patients with UGIB are more than female patients,and there are differences in etiology in different age groups.Elderly patients have higher treatment costs,combined with hypertension,coronary heart disease,blood transfusion,and long hospitalization time are also risk factors for high treatment costs.