汕头市潮南区住院糖尿病足患者经济负担调查研究

Study on economic burden of patients with diabetic foot in a rural area in Shantou city

目的调查汕头市潮南区住院糖尿病足(diabetic foot,DF)患者的经济负担情况。方法选择汕头潮南民生医院2014年1月至2015年12月住院部收治的88例农村糖尿病足患者为研究对象,分析其临床特点及住院费用。结果 88例糖尿病足患者平均年龄为(66.6±11.0)岁,中学以下文化占98.9%,平均Hb A1c为(10.23±2.90)%,平均合并症为(2.56±1.34)种。平均住院时间为13(8.5~22.0)d,平均治疗总费用为11 241.32(8 073.20~17 557.41)元,其中平均药物费为6 072.11(3 996.92~9 497.81)元、平均检验费为1 368.19(989.49~1 919.36)元、平均检查费为996.7(507.9~1 552.0)元。患者住院天数在不同Wagner分级的组间差异有统计学意义(P<0.05);住院总费用、药物费用在不同Wagner分级间差异无统计学意义(P>0.05)。结论汕头农村地区糖尿病足患者具有年龄大、文化程度低、血糖控制不良、合并症多的特点,住院费用高昂,采用多种措施减少糖尿病足的发生是降低住院费用的关键环节。

Objective To explore the economic burden of patients with diabetic foot(DF) in Chaonan district which was a rural area in Shantou city. Methods The clinical features and the medical expenses of 88 patients hospitalized for diabetic foot in the Shantou Chaonan Minsheng Hospital from January,2014 to December, 2015 were analyzed. Results Of 88 studied patients with diabetic foot, the average age was(66.6±11.0) years; median hospitalization period was 13(8.5-22.0) days; the average kinds of complications were(2.56±1.34) and the mean Hb A1 clevel was(10.23±2.90)%. The median cost during hospitalization was 11 241.32(8 073.20-17 557.41) RMB, including 6 072.11(3 996.92-9 497.81)RMB for drugs, 1 368.19(989.49-1 919.36) RMB for image inspection, and 996.7(507.9-1 552.0)RMB for laboratory tests. 98.9% of these patients graduated from middle school or had lower education level. There were significant differences in the length of hospital stay among patients with different Wagner grades(P<0.05). There was no significant difference in the total cost of hospitalization and drug fee between different Wagner grades(P>0.05). Conclusions Patients with diabetic foot in rural areas of Shantou tend to be at elder ages, have lower education levels and poorer glycemic control, and more complications. The hospitalization burden is extremely heavy for the patients with diabetic foot in rural areas of Shantou, and the key to reduce the hospitalization expense is to decrease the incidence of diabetic foot.