山西省184家医院40岁以上脑卒中患者住院人次及住院费用分析

目的分析山西省40岁以上脑卒中住院患者流行病学特征及住院费用的影响因素。方法收集山西省医疗机构服务能力分析与评估系统平台中184家医院的病案首页数据,结合全球疾病负担及第十版国际疾病分类(ICD-10)筛选脑卒中住院患者,采用SPSS 20.0进行流行病学和多元逐步回归分析,利用Arcgis10.2绘制统计地图。结果脑卒中住院患者共计714893人次,缺血性脑卒中与出血性脑卒中分别占87.99%和12.01%。2013-2017年,脑卒中患者人次明显上升;3-5月、10-12月最多,1-2月、6-8月最少。60～69岁住院人次最多(32.27%),40～49岁最少(9.32%),男女比例1.4:1。太原市脑卒中住院人次占比最高(3.61%),忻州市最低(0.85%)。脑卒中患者住院费用影响因素依次为住院天数、脑卒中分型、医院等级、是否危急、是否执行临床路径、是否单病种、性别、是否感染、年龄。结论应采取预防及控制措施,重点保护男性中老年高危人群,预防出血性脑卒中等危重病情的发生。采取规范的医疗方案、缩短住院天数,进而减轻脑卒中患者的经济负担。

Analysis of Stroke Inpatients and Hospitalization Expenses over 40 Years Old in 184 Hospitals in Shanxi Province

Objective To analyze the epidemiological characteristics of inpatients with stroke above 40 years old and the influencing factors of hospitalization expenses in Shanxi province.Methods Collecting the data of the first page of medical records of 184 hospitals from service capacity analysis and evaluation system of medical institutions in Shanxi Province,and screening stroke inpatients by global burden of disease and the International Classification of Diseases,10 th Revision.Using SPSS 20.0 for epidemiological and multivariate regression analysis,and ArcGIS 10.2 for drawing statistical maps.Results A total of 714893 inpatients with stroke were included,and ischemic and hemorrhagic stroke accounted for 87.99% and 12.01% respectively.Stroke inpatients were the most in 3-5 and 10-12 months,the least in 1-2 and 6-8.From 2013 to 2017,the number of stroke patients increased significantly.The maximum number of hospitalization aged 60~69(32.27%)and the least(9.32%)in 40~49 group.The proportion of male and female patients was 1.4:1.The proportion of stroke patients in Taiyuan was the highest(3.606%)and Xinzhou was the lowest(0.849%).The influencing factors of hospitalization cost in stroke patients were hospitalization days,stroke type,hospital grade,critical condition,whether to carry out clinical pathway,whether single disease,sex,infection,age.Conclusion Some prevention and control measures should be taken for it.For example,focusing on protecting high-risk groups of middle-aged males, and preventing the occurrence of hemorrhagic stroke.At the same time,we should adopt normative medical behaviors,shorten hospitalization days rationally,and reduce the economic burden of stroke inpatients.