摘要
目的了解全髋关节置换术患者的住院费用水平,探讨产生超高住院费用的影响因素,为合理控制医疗费用提供参考依据。方法收集北京市某三甲医院在2017年01月01日-2020年12月31日期间出院的全髋关节置换术患者的病案首页信息,描述患者的一般情况,并采用多因素Logistic回归分析的方法探讨超高住院费用产生的影响因素。结果本研究共纳入7,548例研究对象,其中超高费用组患者1,510例;平均住院费用为8.41(7.52-9.51)万元;多因素Logistic回归分析的结果显示:病人来自外省市(OR=1.58,95%CI:1.36-1.83,P<0.001),年龄每增加1岁(OR=0.98,95%CI:0.98-0.99,P<0.001),付费方式为新型农村合作医疗(OR=1.47,95%CI:1.23-1.74,P<0.001),住院天数每增加1天(OR=1.17,95%CI:1.15-1.19,P<0.001),本次住院期间曾入过ICU(OR=2.88,95%CI:1.88-4.41,P<0.001);术前有慢性疾病数量(1个:OR=1.21,95%CI:1.05-1.39,P=0.008;2个:OR=1.37,95%CI:1.14-1.64,P<0.001;≥3个:OR=1.41,95%CI:1.16-1.72,P<0.001)与超高住院费用显著相关。结论患者来自外省市、年龄较小、付费方式为新型农村合作医疗、入院期间在ICU接受过治疗、住院天数每增加1天、术前有慢性疾病是产生超高住院费用的危险因素。控制人工关节的材料费、增强患者慢性病的防治意识、合理缩短住院天数,是控制全髋关节置换术住院费用的重要措施。
Objectives To describe the level of hospitalization cost of total hip arthroplasty patients,to explore the influencing factors of ultra-high costs and to provide evidence for reasonable control of medical expenses.Methods To extract medical record front pages information from patients who underwent total hip arthroplasty between January 1st,2017 and December 31st,2020,to describe the main characteristics of the patients,and to explore the influencing factors of ultra-high costs using multivariable logistic regression analysis.Results A total of 7,548 cases were included in this study,of which 1,510 were ultra-high costs patients.The median total hospitalization cost was 84.10(75.20-95.10)thousand Yuan;Multivariable logistic regression analysis showed that patients from foreign cities(OR=1.58,95%CI:1.36-1.83,P<0.001),each 1-year increase in age(OR=0.98,95%CI:0.98-0.99,P<0.001),paid by rural new cooperative medical scheme(OR=1.47,95%CI:1.23-1.74,P<0.001),each additional day of hospitalization(OR=1.17,95%CI:1.15-1.19,P<0.001),ICU admission during this hospitalization(OR=2.88,95%CI:1.88-4.41,P<0.001),number of chronic diseases before surgery(1:OR=1.21,95%CI:1.05-1.39,P=0.008;2:OR=1.37,95%CI:1.14-1.64,P<0.001;≥3:OR=1.41,95%CI:1.16-1.72,P<0.001)were significantly associated with ultra-high hospitalization costs.Conclusions Patients from other provinces and cities,young age,payment method of new rural cooperative medical care,ICU treatment during hospitalization,the length of stay increased by 1 day each,and chronic disease before surgery were risk factors for excessive hospitalization costs.Controlling the cost of materials for artificial joint,enhancing the consciousness of prevention and treatment of chronic diseases,and shortening the length of hospitalization reasonably were important measures to control the cost of total hip replacement.
作者
李雅慧
袁蕊
刘雪娇
Li Yahui;YuanRui;Liu Xuejiao(Beijing Jishuitan Hospital,Beijing 100035,China;不详)
出处
《中国病案》
2023年第8期72-75,共4页
Chinese Medical Record
关键词
全髋关节置换术
住院费用
影响因素
Department of Medical Record Management and Statistics
Beijing Jishuitan Hospital
Capital Medical University
