2型糖尿病患者住院日均费用影响因素及中药治疗经济效益分析

Influencing factors of average daily cost of hospitalization in patients with type 2 diabetes mellitus and economic benefit analysis of traditional Chinese medicine treatment

目的探讨2型糖尿病(T2DM)住院患者住院日均费用的影响因素,分析使用中药的经济效益,为更加合理、有效地使用卫生医疗资源提供参考依据。方法采用真实世界研究方法,选取2010-2020年福建中医药大学多学科远程协同科研平台数据库中4所附属医院糖尿病住院患者9097例作为研究对象,从电子病历信息系统获取性别、年龄、住院日、主要及其他诊断名称及疾病编码、临床用药情况、住院日均费用、总费用等信息,采用非参数秩和检验分析住院日均费用的影响因素,采用单因素方差分析探讨中药经济效益,用贴现法对住院日均费用进行调整。结果性别、年龄、住院日、用药情况、药占比为住院日均费用的影响因素,差异均有统计学意义(P<0.05);男性患者住院日均费用明显高于女性,≥70岁男性T2DM患者住院日均费用明显高于女性,差异均有统计学意义(P<0.05);与单独使用西药患者比较,西药联合中成药组、西药联合中草药患者住院日均费用均较低,差异均有统计学意义(P<0.05)。结论男性和老年T2DM群体的健康教育与管理亟须受到关注和改善。建立中西医优势互补的临床诊疗体系、发挥中医药在T2DM防治中的优势作用对减少T2DM患者疾病相关并发症,以及对减轻患者、社会和国家的经济负担具有重要意义。

Objective To explore the influencing factors of inpatient average daily cost of type 2 diabetes mellitus(T2DM),analyze the economic benefits of traditional Chinese medicine,and provide reference for more rational and effective use of medical resources.Methods A total of 9097 inpatients with diabetes mellitus in four affiliated hospitals of Fujian University of Traditional Chinese Medicine from 2010 to 2020 were selected from the database of the multidisciplinary remote collaborative research platform in the real world.The information of gender,age,length of stay,major and other diagnostic names and disease codes,clinical medication,average daily cost and total cost were obtained from the electronic medical record information system.Non-parametric rank sum test was used to analyze the influencing factors of average daily cost of hospitalization.One-way analysis of variance was used to explore the economic benefits of traditional Chinese medicine,and the average daily cost of hospitalization was adjusted by discount method.Results Gender,age,length of stay,drug use and drug proportion were the influencing factors of average daily hospitalization expenses,and the differences were statistically significant(P<0.05).The average daily hospitalization cost of male was higher than that of female patients,with statistical significance(P<0.05).Compared with patients who used western medicine alone,the average daily hospitalization cost in Western medicine combined with Chinese medicine group and Western medicine combined with Chinese herbal medicine were lower,and the differences were statistically significant(P<0.05).Conclusion The health education and management of male and elderly T2DM population need to be paid attention to and improved.Establishing a clinical diagnosis and treatment system with complementary advantages of traditional Chinese medicineand western medicine and giving full play to the dominant role of traditional Chinese medicine in the prevention and treatment of T2DM is of great significance for reducing disease-related complications in T2DM patients and reducing the economic burden on patients,society and the country.