[1]张琪 魏丹 高玥珊 蒋婷婷 陈茜.940例老年慢病终末期患者住院费用影响因素分析[J].中国卫生质量管理,2024,31(04):037-42.[doi:10.13912/j.cnki.chqm.2024.31.4.08]
ZHANG Qi,WEI Dan,GAO Yueshan,et al.Analysis of Influencing Factors of Hospitalization Cost in 940 Elderly Patients with End-Stage Chronic Disease[J].Chinese Health Quality Management,2024,31(04):037-42.[doi:10.13912/j.cnki.chqm.2024.31.4.08]
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940例老年慢病终末期患者住院费用影响因素分析(
)
《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]
- 卷:
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第31卷
- 期数:
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2024年04期
- 页码:
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037-42
- 栏目:
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医疗质量
- 出版日期:
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2024-04-15
文章信息/Info
- Title:
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Analysis of Influencing Factors of Hospitalization Cost in 940 Elderly Patients with End-Stage Chronic Disease
- 作者:
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张琪 魏丹 高玥珊 蒋婷婷 陈茜
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四川大学华西医院老年医学中心/四川大学华西护理学院
- Author(s):
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ZHANG Qi; WEI Dan; GAO Yueshan; et al
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Geriatrics Center,West China Hospital,Sichuan University/West China School of Nursing
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- 关键词:
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慢性疾病; 终末期; 老年患者; 住院费用
- Keywords:
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Chronic Diseases; End-Stage; Elderly Patients; Hospitalization Expenses
- 分类号:
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R197.3
- DOI:
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10.13912/j.cnki.chqm.2024.31.4.08
- 文献标志码:
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A
- 摘要:
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目的探讨老年慢病终末期患者住院费用影响因素,为控制医疗费用增长和促进安宁疗护发展提供参考。方法回顾性分析某院2021年1月1日-12月31日940例老年慢病终末期死亡患者病历资料,采用描述性分析、单因素方差分析、多元线性回归分析等对住院费用及影响因素进行统计分析。结果老年慢病终末期患者住院天数中位数为13 d,住院费用中位数为59 817.91元。住院天数、手术、转ICU、付费方式、使用胃管、使用气管插管、入院途径等为老年慢病终末期患者住院费用的主要影响因素(P<0.05)。结论老年慢病终末期患者住院费用受多种因素影响。建议推广价值医疗理念,推行DRG/DIP付费制度,优化临床路径,建立综合医院与安宁疗护机构双向转诊制度,推广预立医疗照护计划等,提高患者生存质量,减少医疗资源浪费。
- Abstract:
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ObjectiveTo explore the factors influencing the hospitalization expenses of elderly patients with end-stage chronic diseases, and to provide reference for controlling the increase of medical expenses and promoting the development of hospice care.MethodsThe medical records of 940 elderly patients with end-stage death from chronic diseases in a hospital from January 1 to December 31, 2021 were retrospectively analyzed. Descriptive analysis, one-way analysis of variance and multiple linear regression were used to make statistical analysis of hospitalization costs and influencing factors.ResultsThe median length of hospitalization was 13 days and the median cost of hospitalization was 59 817.91 yuan. Length of stay, operation, ICU transfer, payment method, use of gastric tube, tracheal intubation and admission route were the main influencing factors of hospitalization cost in elderly patients with end-stage chronic diseases(P<0.05).Conclusion The hospitalization cost of elderly patients with end-stage chronic diseases was affected by many factors. It is suggested to promote the concept of value medicine, implement the DRG/DIP payment system,optimize clinical pathways, establish a two-way referral system between general hospitals and hospice institutions, popularize pre-established medical care plans, etc., so as to improve the quality of life of patients and reduce the waste of medical resources.
参考文献/References:
[1]李明燚.2018年长春市居民四种慢性病患病现状及其影响因素研究[D].长春:吉林大学,2020.[2]LEVOY K,TARBI EC,DE SANTIS JP.End-of-life decision making in the context of chronic life-limiting disease:a concept analysis and conceptual model[J].Nursing Outlook,2020,68(6):784-807. [3]LANGTON JM,BLANCH B,DREW AK,et al.Retrospective studies of end-of-life resource utilization and costs in cancer care using health administrative data:a systematic review[J].Palliative Medicine,2014,28(10):1167-1196. [4]魏 宁,周绿林,张 磊.中老年人口去世前一年医疗费用支出影响因素研究[J].卫生经济研究,2017(6):27-29.[5]AKHLAGHI E,LEHTO RH,TORABIKHAH M,et al.Chemotherapy use and quality of life in cancer patients at the end of life:an integrative review[J].Health and Quality of Life Outcomes,2020,18(1):332. [6]刘 杰,口锁堂,汪听亚,等.腰椎间盘突出症患者住院费用影响因素分析[J].中国卫生质量管理,2021,28(9):22-24. [7]于洗河,降海蕊,贾欢欢,等.吉林省某三甲医院心脑血管疾病患者住院费用影响因素分析[J].医学与社会,2021,34(2):12-16. [8]HAZRATI E,MESHKANI Z,BARGHAZAN SH,et al.Determinants of hospital inpatient costs in the iranian elderly:a micro-costing analysis[J].J Prev Med Public Health,2020,53(3):205-210. [9]董 乾,王富敏,刘厚福,等.DRG对住院费用与服务的影响及建议[J]. 中国卫生质量管理,2021,28(12):22-25. [10]陈继芳,白丽萍,谭卉妍,等.广东省按病种分值付费实践及对医院医保管理的启示[J].中国医院管理,2022,42(3):63-66.[11]龙雨曦,袁向东,黎 浩.我国医保支付改革下按病种分值付费的探讨与建议[J].中国卫生质量管理,2022,29(4):18-20,29.[12]ZHANG J,SUN L.Analysis of influencing factors on hospitalization expenses of patients with breast malignant tumor undergoing surgery:based on the neural network and support vector machine[J].Journal of Healthcare Engineering,2021:9268660. [13]陈彦东,杨鑫禹,王 颖,等.老年原发性肺癌患者住院费用及影响因素[J].中国老年学杂志,2020,40(18):3986-3989. [14]CHUNG TH,NGUYEN LK,LAL LS,et al.Palliative care consultation in the intensive care unit reduces hospital costs:a cost-analysis[J].J Palliat Care,2022,undefined:8258597221095986.[15]JEON SM,KWON JW,CHOI SH,et al.Economic burden of lung cancer:a retrospective cohort study in South Korea,2002-2015[J].PloS One,2019,14(2):e0212878.[16]SNCHEZ-SNCHEZ E,RUANO-LVAREZ MA,DAZ-JIMNEZ J,et al. Enteral nutrition by nasogastric tube in adult patients under palliative care:a systematic review[J].Nutrients,2021,13(5):1562. [17]HUNG YN,LIU TW,WEN FH,et al.Escalating health care expenditures in cancer decedents’ last year of life:a decade of evidence from a retrospective population-based cohort study in Taiwan[J].Oncologist,2017,22(4):460-469. [18]HWANG J,SHEN J,KIM SJ,et al.Ten-year trends of utilization of palliative care services and life-sustaining treatments and hospital costs associated with patients with terminally ill lung cancer in the United States from 2005 to 2014[J].The American Journal of Hospice & Palliative Care,2019,36(12):1105-1113. [19]KLINGLER C,IN DER SCHMITTEN J,MARCKMANN G.Does facilitated Advance Care Planning reduce the costs of care near the end of life?Systematic review and ethical considerations[J].Palliative Medicine,2016,30(5):423-433. [20]王 隽,胡春平,王 沅.以价值医疗为导向的DRG付费制度剖析[J].卫生软科学,2022,36(2):40-42. [21]王若薇,孔凡磊,韦苏晴,等.山东省老年肿瘤患者住院费用及影响因素分析:以某医院住院老年肿瘤患者为例[J].中国农村卫生事业管理,2021,41(5):316-321.[22]LI Z,PAN Z,ZHANG L,et al. End-of-life cost and its determinants for cancer patients in urban China:a population-based retrospective study[J].BMJ Open,2019,9(3):e026309. [23]周立业,夏鑫婧,郭志飞,等.山西省运城市某三甲医院冠心病患者住院费用影响因素研究[J].医学与社会,2022,35(11):116-122.
更新日期/Last Update:
2024-04-15