新发脑卒中患者住院费用构成及影响因素分析

目的了解脑卒中患者住院费用构成和影响因素，探讨有效降低脑卒中住院费用的方法。方法2011年7-12月佛山市第一人民医院、中山大学第二附属医院、佛山市中医院神经内科连续人院的新发脑卒中患者共735例。统计患者一般情况、脑卒中类型、合并症、并发症、付费方式，以及住院费用及其构成等，并分析住院费用影响因素。结果新发脑卒中患者平均住院费用为11448．3元，其中药物费占40．1％，仪器检查费占23．0％，诊疗费占15．5％．化验费占13．9％；诊疗费和护理费相对较低。脑卒中发生以老年男性多见，住院时间长、并发症和心房纤颤等增加脑卒中患者的住院费用。结论新发脑卒中患者的住院费用结构仍不合理，药占比过高。控制住院时间，预防并发症的发生，对老年人、尤其是老年男性做好一级预防，加强心房纤颤的防治、管理，能有效降低住院费用。

The expenses of patients with new onset stroke

Objective To estimate the hospitalization expenses of patients with new onset stroke and its influence factors, and discuss the effective method of reducing hospitalization expenses. Method 735 cases of new onset stroke （July 2011 - December 2011） from the Department of Neurology of The First People＇s Hospital of Foshan, the Second Affiliated Hospital of Sun Yat-sen University and Foshan hospital of traditional Chinese medicine were analyzed for the stroke type, comorbidities, complications, modes of payment, as well as the hospitalization expenses. Results The average hospitalization cost for these patients was 11 448.3 yuan, accounting for 40.1% of the drug fees, 23.0% of the instrument examination fees, 15.5% of the medical fees, and 13.9% of the testing fees. Medical fees and the nursing fees were relatively low. The frequency of stroke occurrence was high in elderly. The hospitalization expenses was increased in patients with long periods of hospitalization, complications and atrial fibrillation （AF）. Conclusions The hospitalization expenses of patients with new onset stroke was unreasonably high, especially for the expenses in drug. Controlling the length of hospitalization, prevention of complication and stroke in elderly, especially the male subjects, and strengthening the management of AF can effectively reduce the costs of hospitalization.