Analysis of Hospitalization Costs and Influencing Factors of AKI in Adult Patients

Objective:To investigate the economic burden of patients with acute kidney injury(AKI)by analyzing the distribution of hospitalization expenses and its influencing factors in the Affiliated Hospital of Hebei University.Methods:The hospitalization information of patients with AKI from January 2020 to January 2023 was collected and sorted through the hospital charging system and the factors affecting the total hospitalization cost were analyzed by multiple linear regression.Results:Univariate analysis showed that age,occupation,marriage,length of hospitalization,recovery of renal function,and stage of AKI had significant effects on hospitalization cost(P<0.05).The result of the multiple linear regression analysis model showed that age(t=4.11,P<0.0001),length of hospitalization(t=16.10,P<0.0001),recovery of renal function(t=3.26,P<0.0001),AKI stage(t=5.23,P=0.002)are factors affecting the economic burden of patients with AKI.Conclusion:AKI patients should be managed according to age stratification to effectively control the progression of the disease and improve the quality of the medical services provided.This will reduce the economic burden of patients.

药品集中带量采购对糖尿病患者住院费用的影响

目的评价药品集中带量采购对糖尿病患者住院总费用及各类构成费用的影响。方法基于研究医院的9852份糖尿病患者病案首页数据,整理患者基本信息、医疗服务利用信息及各项医疗费用信息,综合运用普通最小二乘法(ordinary least square,OLS)和倾向性得分匹配法(propensity score matching,PSM)进行数据分析。结果集中带量采购政策确实能够降低糖尿病住院患者的药品费用(t=-2.27,P<0.05),但是对住院总费用、医疗服务性费用影响不显著。OLS回归低估了药品集中带量采购对患者检查化验耗材费用的增费效应(t=2.26,P<0.05)。结论在进一步加强宣传教育的同时,要有序扩大药品集中带量采购,系统推动医药领域集约式改革,持续放大改革红利,实现患者总体医疗负担减轻,让政策福利遍及更多患者。

上海市静安区区级医院慢性肾衰竭患者住院总费用负担评价

目的 对上海市静安区2015—2019年区级医院慢性肾衰竭患者住院总费用负担进行评价,探讨导致住院总费用负担增加的主要因素,为控制住院总费用、减轻患者本人和社会经济压力提供可行性建议。方法 利用基于松弛变量的数据包络分析法对住院总费用技术效率进行测算。结果 各年度的住院总费用技术效率均低于0.8,其中2015年技术效率值最高,而2019年技术效率值最低。各类医疗费用中治疗费和检查化验费技术效率值较低。不同医院之间技术效率值存在显著差异。结论 慢性肾衰竭患者住院总费用负担呈逐年上升趋势。慢性肾衰竭住院患者药费支出较为合理。降低治疗费和检查化验费是控制住院总费用的关键。各医疗机构诊疗行为的不同是造成疾病经济负担差异的重要因素。

Diagnosis related group grouping study of senile cataract patients based on E-CHAID algorithm

AIM： To figure out the contributed factors of the hospitalization expenses of senile cataract patients（HECP） and build up an area-specified senile cataract diagnosis related group（DRG） of Shanghai thereby formulating the reference range of HECP and providing scientific basis for the fair use and supervision of the health care insurance fund.METHODS： The data was collected from the first page of the medical records of 22 097 hospitalized patients from tertiary hospitals in Shanghai from 2010 to 2012 whose major diagnosis were senile cataract. Firstly, we analyzed the influence factors of HECP using univariate and multivariate analysis. DRG grouping was conducted according to the exhaustive Chi-squared automatic interaction detector（E-CHAID） model, using HECP as target variable. Finally we evaluated the grouping results using non-parametric test such as Kruskal-Wallis H test, RIV, CV, etc.RESULTS： The 6 DRGs were established as well as criterion of HECP, using age, sex, type of surgery and whether complications/comorbidities occurred as the key variables of classification node of senile cataract cases.CONCLUSION： The grouping of senile cataract cases based on E-CHAID algorithm is reasonable. And the criterion of HECP based on DRG can provide a feasible way of management in the fair use and supervision of medical insurance fund.