291例重度子痫前期住院费用及影响因素分析

Analysis of Hospitalization Expenses and Influencing Factors of 291 Cases in Severe Pre-eclampsia

目的了解单胎重度子痫前期剖宫产分娩的住院费用情况及其影响因素,为合理控制住院费用提供参考依据。方法采用回顾性研究方法,从某院病案信息系统中检索2019年9月1日-2021年8月31日期间住院的重度子痫前期、≥28周剖宫产为分娩方式、单胎活产的产妇信息作为研究对象,除外胎盘异常及孕前合并慢性疾病的病例,共筛选有效样本291例。以住院费用中位数为分割点分为高费用组和低费用组,计量资料进行正态分布检验,呈非正态分布,采用秩和检验;计数资料采用χ^(2)检验。结果291例SPE剖宫产分娩产妇住院费用中位数为13000.84元,住院费用排在前3位的是化验费、药品费和手术及麻醉费。高费用组的住院天数及住院费用明显高于低费用组,P<0.05,差异具有统计学意义;高费用组和低费用组的住院天数分别是10天和6天,入院孕周的分别是35周和37周,P<0.05,差异具有统计学意义;分娩孕周分别是37周和38周;入院孕周≤32周占比分别是32.9%和11.0%;高费用组的HELLP和内科合并症为54人,占比37%,高于低费用组的16.6%,P<0.05,差异具有统计学意义。2组的年龄、胎盘早剥、产后出血、FGR和胎儿窘迫比较,P>0.05,差异无统计学意义。结论重度子痫前期剖宫产分娩产妇住院费用主要体现在化验费、药品费和手术及麻醉费,高费用组各项费用均高于低费用组;发病孕周早、住院时间长、合并症发生率高是导致住院费用高的主要影响因素。要重视重度子痫前期产妇的监管,做到早发现、早治疗、早干预,合理控制住院费用,减轻患者经济负担。

Objectives To investigate the hospitalization cost and its influencing factors of cesarean section delivery of singleton severe preeclampsia.Methods A retrospective study was conducted to retrieve women hospitalized from September 1,2019 to August 31,2021 with SPE,cesarean delivery at or above 28 weeks,and single live birth,excluding cases of placental abnormalities and pre-pregnancy complicated chronic diseases.The median hospitalization cost was divided into high-cost group and low-cost group.The measurement data showed non-normal distribution and rank sum test was used.The count data were tested by χ^(2) test.Results A total of 291valid samples were selected.The top three hospitalization expenses were laboratory fee,drug fee and operation and anesthesia fee.The length of stay and hospitalization cost in the high-cost group were significantly higher than those in the low-cost group(P<0.001).Admission and gestational age in the high-cost group were earlier than those in the low-cost group(P<0.001,P<0.05).The incidence of complications in the high-cost group was higher than that in the low-cost group(P<0.001).Conclusions The cost of SPE hospitalization was mainly reflected in laboratory fee,drug fee,operation and anesthesia fee,and the high-cost group was higher than the low-cost group.Early onset gestational week,long hospital stay and high incidence of complications were the main factors leading to high hospitalization costs.Attention should be paid to SPE maternal supervision,early detection,early treatment,early intervention,reasonable control of hospitalization costs,reduce the economic burden of patients.