老年住院患者住院医疗费用及其影响因素分析

目的：了解老年患者住院费用构成情况及其影响因素,提出控制老年患者住院医疗费用不合理增长的有效方法。方法：从某三级甲等综合医院2005年1月1日-12月31日全部患者的病历首页数据库中,选取60岁以上住院患者共4439例,对费用构成及影响因素进行分析。结果：老年住院患者住院费用中药费比例最高,占50％以上,其次是特诊费。影响老年患者住院医疗费用的主要因素为住院天数、手术、死亡、疾病、院内感染、入院次数、身份及并发症等。结论：应加强医院标准化管理,减少不必要的临床用药和临床检查,采取综合措施切实降低老年患者住院费用。

Hospitalized Medical Expenses of Elderly Patients and Its Influencing Factors

Objectives： To understand the composition of elderly patients and its influencing factors. Bring forward effective method to control unreasonable growth of the medical expenses paid by elderly patients. Methods： Medical records of 4439 patients over 60 years old were collected from a upper first - class hospital between 2005 - 01 - 01＂and 2005 -12 -31＂, and then the constitute and influencing factors of medical expenses were analyzed. Resuits： Over 50% elderly patients take Chinese tradition medicine fee as their maximum cost, special fee rank second. The main factor which influence medical expenses of elderly patients were length of hospital stay, surgery, death, nosocomial infections, admission of hospital, status , complications and so on. Conclusions： We should strengthen standardization management in hospitals and reduce unnecessary clinical medicine and examination. Also, comprehensive measures are necessary to reduce the hospitalized medical expenses of elderly patients.