495例肝脓肿患者疾病经济负担及其影响因素

目的分析2010-2019年住院治疗的肝脓肿患者基本情况、住院费用及其结构变化和影响因素,评估肝脓肿直接经济负担,探寻有效减轻肝脓肿疾病经济负担的方法。方法回顾性收集中南大学湘雅医院2010年1月-2019年12月收治的495例肝脓肿住院患者资料,分析逐年住院费用变化、各项住院费用变化、各临床特征与住院费用的相关关系,多元逐步回归分析住院费用影响因素。结果 495例病例中,平均住院日为15.93 d,人均住院费用34 548.02元,所有项目费用中西药类占比最高;既往有肝胆手术史、肿瘤病史、治疗过程中合并胸腔积液、肺部感染、采用手术治疗患者住院费用显著升高(P<0.05);多因素回归分析提示住院天数越长、治疗手段越复杂、合并肿瘤史、出现胸腔积液患者住院费用更高。结论 2010-2019年住院治疗肝脓肿人均费用34 548.02元,其中西药费用占比最高,诊断类费用逐年增长,不同特征患者住院费用有差异。住院日、治疗手段、肿瘤史、合并胸腔积液均会对住院费用产生影响。

Economic burden of 495 patients with liver abscess and influencing factors

OBJECTIVE To investigate the baseline data,hospitalization costs,composition and influencing factors of the liver abscess patients hospitalized from 2010 to 2019 and evaluate the direct economic burden of liver abscess so as to seek effective measures to reduce the economic burden.METHODS The data were collected from 495 liver abscess patients who were hospitalized in Xiangya Hospital,Central South University from Jan 2010 to Dec 2019.The hospitalization costs,hospitalization cost of each item and correlation between clinical characteristic and hospitalization cost were observed,and multivariate stepwise regression analysis was performed for the influencing factors for the hospitalization cost.RESULTS Among the 495 patients,the average length of hospital stay was 15.93 days,the hospitalization costs of each patient was 34548.02 yuan,and the proportion of the costs of western drugs was the highest among all the costs of items.The hospitalization costs of the patients with previous hepatobiliary surgery history,history of tumor,pleural effusion and pulmonary infection during treatment were significantly increased(P<0.05).The multivariate regression analysis indicated that the hospitalization costs of the patients with longer length of hospital stay,more complicated treatment means,history of tumor and pleural effusion were higher.CONCLUSION The per capita cost of hospitalization of the patients with liver abscess is RMB 34548.02,the proportion of the cost of medicine is the highest,and the costs of diagnostic items are increased year by year.The length of hospital stay,treatment means,history of tumor and complication with pleural effusion may affect the hospitalization costs.