肝损害患者住院费用影响因素分析

目的 探讨影响肝损伤患者住院费用的因素,以改善医疗质量、降低住院费用.方法 回顾性收集佳木斯大学附属第一医院2007-2012年收治的497例肝损害患者的住院资料,包括基本情况、入院和出院时间及病区、出院情况、有无病理检查、住院期间非常规处置情况和住院费用,采用x2检验和Logistic分析方法进行单因素和多因素分析.结果 2011、2012年住院患者人次较多,占2007-2012年的56.94％,人日均住院总费用和西药费持续上升,年增长率分别为7.80％和9.94％,西药费占总费用的比例高于65.00％.男性多于女性,占62.17％,以31～50岁、9-11月份入院、住院日在6～21 d的患者居多,分别占44.06％、31.79％和75.86％.农民和其他职业者占61.77％,住院期间有非常规处置次数者,占58.95％.Logistic分析表明:性别、年龄、住院日、出院时情况、住院期间非常规处置与人日均住院西药费呈正相关,其中出院时情况对人日均住院西药费影响最大,其次为住院日和住院期间非常规处置.结论 肝损害患者住院费用逐年上升,西药费用所占比例较高.采取中西医结合疗法将有助于患者人日均住院西药费的减少.

Influencing factors on the hospitalization expenses of hepatic injury patients

Objective To analyze the influencing factors of the hospitalization expenses among patients with hepatic injury,so as to improve the medical quality and reduce the costs.Methods A retrospective analysis was conducted for 497 medical records of patients with hepatic injury from 2007 to 2012 in the First Affiliated Hospital of Jiamusi University,including basic information,time of admission to hospital and discharge,inpatient area of admission in hospital and discharge,condition of discharge,pathological examination,status of unconventional treatment and hospitalization expenses.Chi-square test and logistic analysis were adopted for single factor and multiple factors analysis.Results There were more hospitalized patients (56.94％) in 2011 and 2012 than the rest years during 2007 to 2012.The total hospital cost per person per day and the cost of western medicine were increasing gradually with increasing rates per year of 7.80％ and 9.94％ respectively.The percentage of western medicine cost in the total cost was higher than 65.00％.Male was in the majority(62.17％).Patients,who were 31-50 years old,went into hospital from September to November,and whose average hospital days were 6-21 days,were more than others that accounting for 44.06％,31.79％ and 75.86％ respectively.Among all the patients,61.77％ were farmers and other professionals,and 58.95％ had unconventional treatment.The logistic analysis demonstrated that gender,age,hospital days,discharge condition and unconventional treatment had positive correlation with western medicine cost per person per day.The condition of discharge was the most important influencing factor,following by hospital days and unconventional treatment.Conclusions The hospitalization expenses for patients of liver injury are increasing year by year,and the western medicine cost is relatively high.It is necessary to integrate traditional Chinese medicines and western medicines as treatment for reducing the hospitalization expenses.