我国三省新生儿窒息住院费用及影响因素分析

目的研究我国部分地区不同级别医院新生儿窒息的住院费用,并探讨其影响因素,为进一步开展新生儿复苏项目,减轻新生儿窒息疾病经济负担提供建议。方法选择年分娩量较大（〉1000活产/年）的省级医院2所、地市级医院2所、县级医院2所。查找2009年和2010年两年间在上述医院发生的全部新生儿出生窒息病例,从医疗机构2009年和2010年所有符合入选标准的出生窒息住院病例记录中,收集有关出生窒息诊治费用的资料,包括诊断、急救、住院、药品、手术等直接医疗费用进行回顾性调查。结果共调查891例,住院费用均数为5171.8元,各省之间、各级别医院住院费用间差异均有显著性。新生儿出生后1 min Apgar评分、住院天数、不同省份、不同级别医院以及病人来源为住院费用的相关因素。结论加强新生儿复苏技术培训,减少重度窒息的发生,完善疾病诊疗规范,可减少新生儿窒息病例的医疗费用,减轻患儿家庭的经济负担。

Analysis of the medical cost of neonatal asphyxia and the influencing factors in three provinces of China

【Objective】To analysis the medical cost and influencing factors of neonatal asphyxia in selected provinces and provide evidence-based information for interventions reducing the related medical cost.【Methods】Six hospitals（annual live birth 1000） of different level in each of the three provinces were selected to participate in the study.Medical records of neonatal asphyxia case from 2009 to 2010 in each hospital were reviewed and information on medical cost was recordedand analyzed.【Resluts】891 medical records were reviewed and the average medical cost of birth asphyxia was 5171.8 RMB.There was significantly different of medical cost among provinces and hospitals of different level.Apgar score at 1 minute,days of hospitalization,hospital level and place of live were the influencing factors of birth asphyxia medical cost.【Conclusion】In order to decrease the medical cost of neonatal asphyxia and ease the family burden,methods should be taken to strengthen the neonatal resuscitation training to prevent severe birth asphyxia,and to promote the standard diagnosis and treatmentof birth asphyxia.