腔隙性脑梗死临床路径实施效果分析

目的:评价西安市中心医院神经内科腔隙性脑梗死临床路径的实施效果,为全面实施临床路径提供依据。方法:采用t检验比较腔隙性脑梗死单病种实施临床路径前后的住院日和住院费用、患者满意度和健康教育知晓率。结果:腔隙性脑梗死的平均住院日分别下降了1.03d,住院费用分别减少了2331.04元,减少了18.89%。结论:临床路径管理可以有效地减少住院天数、降低医疗费用、缩短治疗周期,提高病床效率,持续改进医疗质量,提高医疗服务效率、节省医疗成本。从而增加患者的满意度和信任,并且使患者健康教育知晓率显著提高。

Rising costs and hospital admissions for hepatocellular carcinoma in Portugal(1993-2005)

AIM:To determine,for hepatocellular carcinoma(HCC),the patient demographic profile and costs of their admissions to the hospitals of the Portuguese National Health System from 1993 to 2005.METHODS:The National Registry(ICD-9CM,Inter-national Classification of Diseases,155.0)provided data from the 97 Hospitals in Portugal.RESULTS:We studied 7932 admissions that progres-sively rose from 292 in 1993 to 834 in 2005,having a male predominance of 78%(6130/7932).The global rate of hospital admissions for HCC rose from 3.1/105 in 1993 to 8.3/105 in 2005.The average length of stay decreased from 17.5 ± 17.9 d in 1993 to 9.3 ± 10.4 d in 2005,P < 0.001.The average hospital mortality for HCC remained high over these years,22.3% in 1993 and 26.7% in 2005.Nationally,hospital costs(in Euros-€)rose in all variables studied:overall costs from €533 000 in 1993,to €4 629 000 in 2005,cost per day of stay from €105 in 1993,to €597 in 2005,average cost of each admission from €1828 in 1993,to €5550 in 2005.In 2005,1.8%(15/834)of hospital admissions for HCC were related to liver transplant,and responsible for a cost of about €1.5 million,corresponding to one third of the overall costs for HCC admissions in that same year.CONCLUSION:From 1993 to 2005 hospital admissions in Portugal for HCC tripled.Overall costs for these admissions increased 9 times,with all variables related to cost analysis rising accordingly.Liver transplant,indicated in a small group of patients,showed a disproportionate increase in costs.

Study of the economic burden and influencing factors on stroke patients in Central China in the post-epidemic era

The economic burden of disease is the main burden of disease for patients,and experts and scholars have done various studies from different perspectives on various types of diseases.In the present study,we focused on the basic situation of hospitalization cost of stroke patients in Hunan Province and analyzed the factors affecting the hospitalization cost of stroke patients.A retrospective random sample of 7270-case home data of patients discharged from several hospitals in Hunan Province with diagnoses of ICD-10 codes I60 to I64 from 2019 to 2021 was used to analyze the patient’s hospitalization costs and the influencing factors.The univariate analysis was used to eliminate irrelevant factors,and multiple linear regression analysis was performed on the effective factors.Patients’medical costs are increasing year by year,with drug costs accounting for a high proportion of patients’hospitalization costs.The ranking of the total effect factors of hospitalization costs was as follows:the number of days of hospitalization,the level of the institution,the disease subtype,gender,the type of participation,and age.It was recommended to strengthen the scientific and rational use of drugs,improve medical technology and service level,do a good job in early screening and prevention of diseases,realize the hierarchical diagnosis and treatment system,play an active role in community hospitals,use medical resources rationally,develop scientific and rational treatment plans,shorten the number of days of hospitalization,control costs effectively,strengthen publicity and education,and form healthy and good living habits to shorten the number of days of hospitalization.The number of days of hospitalization should be shortened.

Healthcare utilization and costs associated with cholangiocarcinoma

Background and aims.Cholangiocarcinoma is a rare but devastating malignancy associated with a poor prognosis and a high mortality rate.With the recent advances in detection and treatment,it is unclear if the incidence and outcomes of cholangiocarcinoma are improving in the United States.The aim of this study was to evaluate the trends in the incidence,costs and mortality rates of cholangiocarcinoma-related hospital admissions in the USA.Methods.We utilized the National Inpatient Sample Database(NIS)from 1997–2012 for all patients in whom cholangiocarcinoma(ICD-9 code 155.1,156)was the principal discharge diagnosis.The temporal trends in the number of hospital admissions,length of stay and,hospitalization costs along with mortality rates over the study period were determined by using regression analysis for trends.Results.There was a significant increase in the number of hospital admissions for cholangiocarcinoma as the principal diagnosis from 1997 to 2012(10357 vs 11970,P<0.001).The mean length of stay for cholangiocarcinoma decreased by 17%between 1997 and 2012 from 9.5 days to 7.9 days(P<0.001).However,during the same period,the mean hospital charges per patient(adjusted for inflation)increased 113.25% from $36460 in 1997 to$77753 in 2012.The in-hospital mortality rate decreased from 9.3% in 1997 to 6.4% in 2012(P<0.001).Conclusions.There was a significant increase in the number of hospital admissions and associated costs from cholangiocarcinoma in the USA between 1997 and 2012.However,this was accompanied by a decrease in the inpatient mortality rates from cholangiocarcinoma.