四川大学华西医院内分泌代谢科2011年糖尿病住院患者费用情况调查

目的 调查四川大学华西医院糖尿病住院患者的费用情况及其与并发症的关系，为进一步研究提供基线数据。 方法 从四川大学华西医院住院电子病历系统（HIS系统）中提取2011年1月1日～2011年12月31日该院内分泌代谢科出院或转他科诊治后出院的住院病例资料，内容包括住院患者基本信息、出院诊断、住院费用及是否在院登记医保等。根据国际疾病分类（ICD-10）标准，对出院记录的各项诊断进行疾病分类，用Excel 2010软件整理数据，并运用SPSS 13.0软件进行统计分析。结果 ① 2011年该科因糖尿病伴急性并发症住院患者占糖尿病住院患者的11.9%（166/1 396）；伴慢性并发症者占67.1%（930/1 396），以糖尿病周围神经病变及周围血管病变最多。② 糖尿病患者中最常见的合并症依次为高血压、血脂异常、骨质疏松症。③ 2011年糖尿病住院患者中位住院天数13天（9～17天），人次中位住院总费用为6 578.88元（4 186.93～10 953.89元）。④ 随着糖尿病慢性并发症数量的增多，住院总费用和住院天数均增加。⑤ 糖尿病足病住院者225人次，中位住院天数为18天（13～29天），人次中位住院总费用为16 672.19元（10 903.93～28 530.37元）；其住院总费用及住院天数均高于非足病患者。结论 糖尿病是内分泌代谢科的重要病种，疾病负担重，其住院费用与糖尿病慢性并发症密切相关，并以糖尿病足病造成的疾病负担最为突出。

Association between Costs and Complication of Diabetes Mellitus Patients in Department of Endocrinology and Metabolism of West China Hospital in 2011

Objective To investigate the association between costs of hospitalized patients with diabetes mellitus and their complications in the West China Hospital of Sichuan University, so as to provide baseline data for further research.
Methods We extracted the hospitalization case data of hospitalized patients with diabetes mellitus who were discharged from the department of endocrinology and metabolism, or discharged after being transferred to other departments for treatment from January 2011 to December 2012, using the hospital information system （HIS） of the West China Hospital of Sichuan University. The data included baseline of hospital patients, discharge diagnosis, hospitalization costs, and if their medical insurance had been registered in hospital. Then, we classified the diseases according to ICD-10 based on discharge diagnosis, coped the data using Excel 2010 software, and conducted statistical analysis using SPSS 13.0.
Results a） In 2011, acute and chronic diabetes complication in diabetes inpatients were 11.9% （166/1 396） and 67.1% （930/1 396）, respectively. Most of them had peripheral neuropathy and peripheral vascular disease. b） The most frequently-occurred complications were hypertension, followed by dyslipidemia, and osteoporosis. c） The median hospital stay was 13 days （7 to 9 days）, and the median total cost of hospital/person-time was 6 578.88 yuan （4 186.93 to 10 953.89 yuan）. d） The total cost and duration of hospitalization increased along with the increasing number of the chronic complications of diabetes. e） The diabetic foot patients were 255 person-times, the median duration of hospitalization was 18 days （13 to 29 days）, and the median total cost of hospital/person-time was 16 672.19 yuan （10 903.93 to 28 530.37 yuan）. Diabetes patients with foot complication had higher total costs and longer duration of hospitalization than those without foot complication.
Conclusion Diabetes mellitus is one of the most important diseases in the department of endocrinology and metabolism, which is heavy disease burden. The costs of hospitalization and chronic complications are closely associated. Among these complications, diabetic foot is the heaviest disease burden.