脑卒中患者住院费用及预后影响因素研究

发布时间：2018-05-23 21:53

本文选题：脑卒中 + 住院费用　；参考：《中国卫生政策研究》2016年05期

【摘要】：目的:揭示以医保类型和职业为代表的社会背景因素对脑卒中患者住院费用差异的影响,以及这种差异对患者预后的影响。方法:对2011—2014年分布在不同省份的5家三甲医院共计18 879例脑卒中住院患者的住院费用和院内死亡情况进行描述性分析,并通过多元线性回归和logistic回归分别分析住院费用和预后的影响因素。结果:在控制了患者人口社会学特征、住院过程和临床特征的前提下,公费医疗患者的费用比自费患者高19.7%(P0.001),退休人群和公务员、企事业单位人员的住院费用分别比农民高4.2%(P0.001)、2.9%(P=0.049);公费医疗患者院内死亡的风险是自费患者的4.901倍(95%CI 1.652~14.537),退休人群院内死亡风险比农民高2.145倍(95%CI 1.287~3.573)。结论:由于社会背景因素的影响,部分患者花费了更多的住院费用,但并不是花费的住院费用越多,脑卒中的预后就越好。
[Abstract]:Objective: to explore the influence of social background factors, such as the type of medical insurance and occupation, on the difference of hospitalization expenses and the prognosis of stroke patients. Methods: the hospital expenses and hospital mortality of 18 879 stroke inpatients in 5 third Class A hospitals in different provinces from 2011 to 2014 were analyzed. Multivariate linear regression and logistic regression were used to analyze the influencing factors of hospitalization cost and prognosis respectively. Results: under the premise of controlling the sociological characteristics of patient's population, hospitalization process and clinical characteristics, the cost of public medical treatment patients was 19.7g / P 0.001 higher than that of self-funded patients, and the retired population and civil servants, The hospital expenses of the personnel of enterprises and institutions were 4.2% higher than that of the peasants, respectively. The risk of death in the hospital of the patients with public medical treatment was 4.901 times that of the patients at their own expense, and the risk of death among the retired people was 2.145 times higher than that of the peasants, and the risk of death in the hospitals was 2.145 times higher than that of the farmers. The risk of death in the hospitals of the patients with public medical treatment was 4.901 times that of the patients at their own expense, and the risk of death among the retired people was 2.145 times higher than that of the peasants. Conclusion: because of the influence of social background, some patients spend more hospital expenses, but not the higher the cost of hospitalization, the better the prognosis of stroke.
【作者单位】：北京协和医学院公共卫生学院;
【基金】：国家自然科学基金(7151101034)
【分类号】：R743.3;R197.323

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