系统性红斑狼疮住院患者西药费用的影响因素

Influencing factors on the hospitalized costs of western medicine on systemic lupus erythematosus patients

目的 分析影响系统性红斑狼疮(SLE)住院患者西药费用的相关因素.方法 收集佳木斯大学附属第一医院2011-2015年收治的191例SLE患者的性别、年龄、入院日期、出院情况、患者来源、医疗付款方式、临床表现、住院总费用和西药费用等资料,以住院西药费用中位数4 487.07元/例为界,分为＜4 487.07例组(96例)和≥4 487.07元组(95例),运用Logistic回归法进行西药费用影响因素分析.结果 2011-2015年191例SLE患者者中女性占96.86％(185例),人均住院西药费占总费用的70.33％,人日均西药费整体有缓慢上升趋势.多因素回归分析显示:26～45岁(OR=1 1.593,95％CI:2.613～51.422)和≥66岁(OR=16.929,95％CI:1.841～55.715)、平均住院日在15～21 d(0R=11.035,95％CI:2.783～43.762)是西药费用较高的危险因素.患者在4-6月入院(OR=0.101,95％CI:0.021～0.482)、出院时病情未愈或死亡情况(OR=0.072,95％CI:0.017～0.297)所用西药费用较低.结论 SLE患者治疗中西药费用占比较高,人日均西药费有上升趋势.临床应结合上述危险因素,重视中青年女性,特别是老年SLE患者的临床诊断,以有效降低SLE患者西药费用.

Objective To analyze the influencing factors on costs of western medicine for systemic lupus erythematosus (SLE) patients.Methods A retrospective study was performed on 191 SLE patients from the First Affiliated Hospital of Jiamusi University during 2011 to 2015.The data of gender,age,admission date,discharge condition,patient source,payment type,clinical manifestations,total hospitalization expenses and western medicine costs were collected.According to the western median expense of 4 487.07 RMB per case,the patients were divided into ＜4 487.07 RMB per case group (96 cases) and ≥4 487.07 RMB per case group (95 cases).Logistic regression analysis was used to determine the risk factors that influenced the costs.Results Among 191 SLE cases during 2011 to 2015,female patients were 96.86％ (185 cases).Its average cost for hospitalization and western medicine was 70.33％ of the total amount.The average daily cost of western medicine increased slowly.The logistic regression analysis showed that the risk factors for the high cost of western medicine were patients of 26-45years old(OR=11.593,95％CI:2.613-51.422),≥66 years old(OR=16.929,95％CI:1.841-55.715)and the average hospitalization days of 15-21d(OR=1 1.035,95％CI:2.783-43.762).However,the admission date between April and June (OR=0.101,95％CI:0.021-0.482) and discharge status of uncured or death(OR=0.072,95％CI:0.017-0.297)spent less on western medicine.Conclusions The cost of western medicine takes high percent during the treatment of SLE patients.The average daily costs of local SLE patients have the rising trend.Our suggestion is to clinically combine the above risk factors,pay attention to young and middle-aged females,and especially the clinical diagnosis of old SLE patients to reduce the western medicine costs of SLE patients.