消化性溃疡伴出血住院患者的诊治费用：在苏州一家医院的研究

发布时间：2018-03-20 16:41

本文选题：消化性溃疡伴出血　切入点：住院费用　出处：《苏州大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：研究消化性溃疡伴出血住院患者的诊治现状及治疗费用，分析住院费用的主要影响因素。方法： 2009年8月至2013年12月期间，收录因消化性溃疡出血住院的患者进行研究。记录并分析患者人口学特征、既往病史、临床表现、住院期间的诊治、住院费用、合并症等，同时对患者住院费用的构成及影响因素进行统计分析。结果：患者平均住院费用为￥6338.8，其中西药费占55.6%，实验室检查费用占14.4%，诊疗护理费用及床位费用占9.3%，器械检查费用占7.4%，，其他费用如内镜下止血、输血费用等约占13.3%。而西药费用中，质子泵抑制剂占41.5%。患者入院时Rockall评分为2.47±1.31。平均住院天数为7.5天。所有的患者在72小时内进行了胃镜检查。其中，十二指肠球部溃疡伴出血占63.1%，胃溃疡伴出血占29.4%，复合溃疡伴出血占6.0%，吻合口溃疡伴出血占1.3%，食管溃疡伴出血0.1%。住院总费用与住院天数、患者年龄、入院时患者血红蛋白水平、胃镜下溃疡Forrest分级、有服用非甾体类抗炎药（NSAIDs）药物史明显相关。结论：影响患者住院费用的主要因素为住院天数、患者年龄、入院时患者血红蛋白水平、胃镜下溃疡Forrest分级、有服用NSAIDs药物史，而呕血、黑便及幽门螺旋杆菌（Hp）感染并不独立影响患者的住院费用，同样的，溃疡类型、溃疡直径、糖尿病等与患者的住院费用无明显相关。文中，质子泵抑制剂占了西药总费用的较大部分，合理的治疗方案有助于降低患者住院费用，同时可优化患者的费用构成。上述影响患者住院费用的因素只能解释患者住院费用的53.3%，说明还有其他影响患者住院总费用的因素，还需要医学工作者进一步探讨。
[Abstract]:Objective:. To study the present situation of diagnosis and treatment of peptic ulcer patients with hemorrhage and the cost of treatment, and to analyze the main influencing factors of hospitalization cost. Methods:. From August 2009 to December 2013, patients with peptic ulcer bleeding were studied. The demographic characteristics, past medical history, clinical manifestations, diagnosis and treatment during hospitalization, hospital expenses, complications, and so on were recorded and analyzed. At the same time, the composition and influencing factors of patients' hospitalization expenses were analyzed statistically. Results:. The average cost of hospitalization was 6338.8, of which western medicine accounted for 55.6, laboratory examination 14.4, consultation and nursing and bed cost 9.3, instrument examination 7.4, other expenses such as endoscopy hemostasis, blood transfusion, etc. Proton pump inhibitors accounted for 41.5% of the patients. The Rockall score at admission was 2.47 卤1.31. The average length of stay was 7.5 days. All patients underwent gastroscopy within 72 hours. Duodenal ulcer with bleeding accounted for 63.1%, gastric ulcer with bleeding accounted for 29.4%, compound ulcer with bleeding accounted for 6.0%, anastomotic ulcer with bleeding 1.3%, esophageal ulcer with bleeding 0.1%. Total hospitalization cost and hospitalization days, patient age, hemoglobin level at admission. The Forrest grade of ulcer under gastroscopy had a history of NSAIDstaking non-steroidal anti-inflammatory drugs (NSAIDs). Conclusion:. The main factors influencing the cost of hospitalization were length of stay, age of patients, hemoglobin level at admission, Forrest grade of ulcer under gastroscopy, history of taking NSAIDs drugs, and hematemesis. Black stool and Helicobacter pylori (HP) infection did not independently affect the cost of hospitalization. Similarly, the types of ulcers, the diameter of ulcers and diabetes were not significantly related to the cost of hospitalization. Proton pump inhibitors account for a large part of the total cost of western medicine. A reasonable treatment plan can help reduce the cost of hospitalization of patients. At the same time, the cost composition of patients can be optimized. The factors mentioned above can only explain 53.3% of the total cost of hospitalization of patients, indicating that there are other factors that affect the total cost of hospitalization of patients, and need to be further explored by medical workers.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R573.1

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