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[2013 - 2014年中国因哮喘急性加重住院患者的临床特征及住院费用多中心回顾性研究]

[A multi-center retrospective study of clinical characteristics and hospitalization costs of patients hospitalized for asthma exacerbation in China during 2013-2014].

作者信息

Lin J T, Xing B, Tang H P, Yang L, Yuan Y D, Gu Y H, Chen P, Liu X J, Zhang J, Liu H G, Wang C Z, Zhou W, Sun D J, Chen Y Q, Chen Z C, Huang M, Lin Q C, Hu C P, Yang X H, Huo J M, Ye X W, Zhou X, Jiang P, Zhang W, Huang Y J, Dai L M, Liu R Y, Cai S X, Xu J Y, Zhou J Y

机构信息

Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2017 Nov 12;40(11):830-834. doi: 10.3760/cma.j.issn.1001-0939.2017.11.007.

Abstract

To study the characteristics of patients hospitalized for asthma exacerbation in 29 teaching hospitals in China and to evaluate the hospitalization costs of these patients. This was a retrospective study and involved patients hospitalized for asthma exacerbation in 29 hospitals throughout China during 2013-2014. Information about the demographic features, conditions before the admission, the outcome, the complications, and the costs was collected using the pre-designed case report form. The influencing factors of the hospitalization costs were analyzed. 3 240 asthmatic patients (1 369 males and 1 871 females) were included and data were analyzed. There were 41.5% (1 346/3 240) patients who had a history of previous hospitalization or emergency department visits during the last year. Only 28.0% (907/3 240) patients had used asthma-controlling medications regularly before the admission. Seventy-three(2.3%) patients were admitted to ICU and used mechanical ventilation. Mortality among these patients hospitalized for asthma exacerbation was 0.25% (8/3 240). The median hospitalization costs was 9 045(6 431, 13 035) RMB. The costs of medications, examinations and treatment accounted for 52.1%, 27.6%, and 9.6% respectively. The costs of asthma medications accounted for only 22.7% of the total medication costs, while the costs of antibiotics accounted for 44.0%. The patients who were admitted to ICU, used mechanical ventilation, complicated with pneumonia, or had a history of hospitalization or emergency department visits during the last year due to asthma exacerbations tended to cost more. In this study, we demonstrated that only a minority of the patients had used asthma controllers regularly before the admissions with exacerbations. The in-hospital mortality of asthma patients in this study was much lower than that reported in other countries. The average cost of hospitalization was much higher than the yearly cost of maintenance therapy. Medication was the predominant component of the total hospitalization costs, and the costs of antibiotics made up the major part of the total medication costs.

摘要

研究中国29家教学医院中因哮喘急性发作住院患者的特征,并评估这些患者的住院费用。这是一项回顾性研究,纳入了2013 - 2014年期间在中国29家医院因哮喘急性发作住院的患者。使用预先设计的病例报告表收集有关人口统计学特征、入院前病情、结局、并发症和费用的信息。分析住院费用的影响因素。共纳入3240例哮喘患者(男性1369例,女性1871例)并进行数据分析。41.5%(1346/3240)的患者在过去一年中有过住院或急诊就诊史。入院前只有28.0%(907/3240)的患者规律使用哮喘控制药物。73例(2.3%)患者入住重症监护病房并使用机械通气。这些因哮喘急性发作住院患者的死亡率为0.25%(8/3240)。住院费用中位数为9045(6431,13035)元人民币。药物、检查和治疗费用分别占52.1%、27.6%和9.6%。哮喘药物费用仅占总药物费用的22.7%,而抗生素费用占44.0%。入住重症监护病房、使用机械通气、合并肺炎或过去一年因哮喘急性发作有过住院或急诊就诊史的患者费用往往更高。在本研究中,我们表明,在急性发作入院前,只有少数患者规律使用哮喘控制药物。本研究中哮喘患者的院内死亡率远低于其他国家报告的死亡率。住院平均费用远高于维持治疗的年度费用。药物是住院总费用的主要组成部分,抗生素费用占总药物费用的主要部分。

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