| 成都市2型糖尿病及其并发症住院费用影响因素分析 |
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| 引用本文： | 胡玲,余芳雪,贾曙光,何卓远,窦丰满,邓燕,赵星,刘祥,刘元元.成都市2型糖尿病及其并发症住院费用影响因素分析[J].现代预防医学,2022,0(11):2012-2018. |
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| 作者姓名： | 胡玲 余芳雪 贾曙光 何卓远 窦丰满 邓燕 赵星 刘祥 刘元元 |
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| 作者单位： | 1. 四川大学华西公共卫生学院/四川大学华西第四医院,四川 成都 610041; 2.成都市医学信息研究所; 3.四川省医学科学院·四川省人民医院,心血管超声及心功能科,超声心脏电生理学与生物力学四川省重点实验室 |
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| 摘 要： | 目的 了解2型糖尿病住院患者的住院费用和糖尿病并发症的关系,分析影响2型糖尿病住院患者住院费用的因素。方法 利用2020年成都市综合性医院糖尿病住院患者的病案首页信息,对成都市276家综合医院的糖尿病及其并发症的住院费用进行分析,并建立多水平模型分析糖尿病患者住院费用的影响因素。结果 本研究纳入62 436例2型糖尿病患者,其中34 919人(55.93%)患有糖尿病相关并发症,糖尿病患者住院费用中位数为7 569.51元。诊断类和西药类费用为住院费用的主要贡献者,分别占38.96%和15.96%。多水平模型分析结果显示,影响2型糖尿病患者住院总费用的因素除了并发症数量(β=0.003, P<0.001)以外,还有年龄40～59岁(β=0.030, P<0.001)、年龄≥60岁(β=0.054, P<0.001)、丧偶(β=-0.025, P=0.001)、离婚(β=-0.014, P=0.044)、其他婚姻状态(β=-0.023, P=0.048)、无业人员(β=0.027, P<0.001)、少数民族(β=-0.019, P=0.011)、住院天数9～14天(β=0.209, P<0.001)、住院天数15～21天(β=0.378, P<0.001)、住院天数≥22天(β=0.591, P<0.001)、医保支付(β=0.095, P<0.001)、公费医疗(β=0.079, P<0.001)、其他付费方式(β=0.089, P<0.001)、二级医院(β=0.193, P<0.001)、三级医院(β=0.392, P<0.001)、病情危重(β=0.106, P<0.001)。结论 大部分2型糖尿病患者患有并发症,并发症增加了患者的经济负担,住院费用和住院天数随着并发症数量增加而增加。建议科学有效地预防和干预并发症,从而降低住院费用。
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| 关 键 词： | 2型糖尿病 住院费用 糖尿病并发症 影响因素 |
Analysis of medical expenses of inpatients with diabetes and its complications,Chengdu |
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| HU Ling,YU Fang-xue,JIA Shu-guang,HE Zhuo-yuan,DOU Feng-man,DENG Yan,ZHAO Xing,LIU Xiang,LIU Yuan-yuan.Analysis of medical expenses of inpatients with diabetes and its complications,Chengdu[J].Modern Preventive Medicine,2022,0(11):2012-2018. |
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| Authors: | HU Ling YU Fang-xue JIA Shu-guang HE Zhuo-yuan DOU Feng-man DENG Yan ZHAO Xing LIU Xiang LIU Yuan-yuan |
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| Affiliation: | *West China School of Public Health/West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China |
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| Abstract: | Objective To understand the relationship between hospitalization expenses of type 2 diabetes inpatients and diabetes complications and analyze the factors that affect hospitalization expenses of type 2 diabetes inpatients. Methods The information on the first page of medical records of inpatients with diabetes in Chengdu general hospitals in 2020 was used, the hospitalization expenses of diabetes and its complications in 276 general hospitals in Chengdu were analyzed, and a multilevel model was established to analyze the impact of hospitalization expenses for diabetes patients’ factor. Results This study included 62 436 patients with type 2 diabetes, 34 919(55.93%)of them had diabetes-related complications, and the median hospitalization cost of diabetes patients was 7 569.51 yuan. Diagnosis and western medicine expenses are the main contributors to hospitalization expenses, accounting for 38.96% and 15.96% respectively. The results of multilevel model showed that in addition to the number of complications(β=0.003, P<0.001), factors affecting the total hospitalization costs of type 2 diabetes patients include age 40-59 years(β=0.030, P<0.001), age ≥60 years(β=0.054, P<0.001), widowed(β=-0.025, P=0.001), divorced(β=-0.014, P=0.044), other marital status(β=-0.023, P<0.048), unemployed(β=0.027, P< 0.001), ethnic minority(β=-0.019, P<0.011), number of days in hospital 9-14 days(β=0.209, P<0.001), number of days in hospital 15-21 days(β=0.378, P<0.001), number of days in hospital ≥22 days(β=0.591, P<0.001), paid by health insurance(β=0.095, P<0.001), publicly funded medical care(β=0.079, P<0.001), other payment methods(β=0.089, P<0.001), secondary hospital(β=0.193, P<0.001), tertiary hospital(β=0.392, P<0.001), critical illness(β=0.106, P<0.001). Conclusion Most patients with type 2 diabetes suffer from complications. Complications increase the economic burden of patients. With the increase in the number of complications, the hospitalization expenses and length of stay increase significantly. It is recommended to prevent and intervene in complications scientifically and effectively to reduce the cost of hospitalization. |
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| Keywords: | Type 2 diabetes Hospitalization costs Diabetes complications Factors |
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