940例老年慢病终末期患者住院费用影响因素分析

Analysis of Influencing Factors of Hospitalization Cost in 940 Elderly Patients with End-Stage Chronic Disease

目的探讨老年慢病终末期患者住院费用影响因素,为控制医疗费用增长和促进安宁疗护发展提供参考。方法回顾性分析某院2021年1月1日-12月31日940例老年慢病终末期死亡患者病历资料,采用描述性分析、单因素方差分析、多元线性回归分析等对住院费用及影响因素进行统计分析。结果老年慢病终末期患者住院天数中位数为13 d,住院费用中位数为59817.91元。住院天数、手术、转ICU、付费方式、使用胃管、使用气管插管、入院途径等为老年慢病终末期患者住院费用的主要影响因素(P<0.05)。结论老年慢病终末期患者住院费用受多种因素影响。建议推广价值医疗理念,推行DRG/DIP付费制度,优化临床路径,建立综合医院与安宁疗护机构双向转诊制度,推广预立医疗照护计划等,提高患者生存质量,减少医疗资源浪费。

Objective To explore the factors influencing the hospitalization expenses of elderly patients with end-stage chronic diseases,and to provide reference for controlling the increase of medical expenses and promoting the development of hospice care.Methods The medical records of 940 elderly patients with end-stage death from chronic diseases in a hospital from January 1 to December 31,2021 were retrospectively analyzed.Descriptive analysis,one-way analysis of variance and multiple linear regression were used to make statistical analysis of hospitalization costs and influencing factors.Results The median length of hospitalization was 13 days and the median cost of hospitalization was 59817.91 yuan.Length of stay,operation,ICU transfer,payment method,use of gastric tube,tracheal intubation and admission route were the main influencing factors of hospitalization cost in elderly patients with end-stage chronic diseases(P<0.05).Conclusion The hospitalization cost of elderly patients with end-stage chronic diseases was affected by many factors.It is suggested to promote the concept of value medicine,implement the DRG/DIP payment system,optimize clinical pathways,establish a two-way referral system between general hospitals and hospice institutions,popularize pre-established medical care plans,etc.,so as to improve the quality of life of patients and reduce the waste of medical resources.