老年皮肤病患者住院费用及其影响因素的通径分析

Path Analysis of Hospitalization Expenses and Influencing Factors of Elderly Dermatological Patients

目的:探讨影响老年皮肤病患者住院费用的主要因素,为降低患者疾病负担,合理抑制疾病负担的过快增长提供参考。方法:通过对广东省某大型三级甲等皮肤病专科医院的住院患者2015——2019年五年病案数据进行描述性分析以及应用通径分析方法探讨老年皮肤病患者住院费用的关键因素。结果:本研究共纳入5584例患者数据进行分析,平均住院费用9141.08元,中位住院费用7622.14元,平均住院日9.36天,中位住院日8天。其中住院天数为最主要的影响因素,性别、是否医保、是否合并症直接作用于住院总费用;是否手术、是否使用抗菌药物、病例分型不仅直接作用于住院费用,并且通过住院天数间接影响住院费用。结论:降低老年皮肤病患者住院费用的突破口为缩短平均住院日。采取分级诊疗措施,控制可控因素,有效降低老年皮肤病患者住院费用,减轻疾病负担。

Objective:To explore the major factors on hospitalization expenses ofelder patients with dermatosis,provide a reference for reducing the disease burden of patients and reasonably restraining the excessive growth of the disease burden.Methods:Through the descriptive analysis of the five-year medical record data of inpatients in a certain large grade A tertiary dermatology hospital in Guangdong Province from 2015 to 2019 and the application of path analysis to explore the key factors of the hospitalization expenses of elderly patients with dermatology.Results:For the 5584 patients analyzed,the average total medical expenses was 9141.08 yuan with a median of 7,622.14 yuan.The per capita hospitalization was 9.36 days,in addition the median is 8 days.Hospitalization day is the most essential factor in hospitalization expense.Gender,medical insurance and complications only influenced the hospitalization costs directly.Surgical operation,antibacterial drugs,disease types not only have direct effects,but also indirect effects on hospitalization expensesthrough the number of days in hospital.Conclusion:The breakthrough to reduce the hospitalization cost of elderly dermatologicalpatients is to shorten the average hospitalization day.Taking hierarchical diagnosis and treatment measures and controlling controllable factors can effectively reduce the hospitalization expenses of elderly dermatological patients and reduce the burden of disease.