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中国北京 2012-2015 年急性缺血性脑卒中患者住院费用分析。

Analysis of Hospital Charges of Inpatients with Acute Ischemic Stroke in Beijing, China, 2012-2015.

机构信息

Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.

Department of Epidemiology and Biostatistics, Institute of Basic Medicine Sciences Chinese Academy of Medical Sciences and School of Basic Medicine Peking Union Medical College, Beijing, China.

出版信息

Neuroepidemiology. 2018;50(1-2):63-73. doi: 10.1159/000484212. Epub 2018 Feb 8.

Abstract

BACKGROUND

The study aimed to analyze the hospital charges of the inpatients with acute ischemic stroke in Beijing and determine the factors associated with hospital costs.

METHODS

Medical records of hospitalized patients with a primary diagnosis of ischemic stroke according to International Classification of Diseases 10th Revision codes were collected from 121 hospitals in Beijing from March 1, 2012, to February 28, 2015. Distribution characteristics of hospital charges for different hospital levels (level 2 hospitals and level 3 hospitals) and types (Western medicine hospitals and Chinese medicine hospitals) were studied. Linear regression analysis was used to examine the association among hospital costs and factors that influenced total hospital charges.

RESULTS

There were 158,781 admissions for ischemic stroke, 63.1% of the patients were male and their mean age was 67.7 ± 12.4 years, the median length of hospital stay (LOHS) was 13.5 days (interquartile range 9.9-18.1 days). The median hospital charge was 2,112 (1,436-3,147) US dollars. Of these, 46.7% were for medicine, 21.1% for laboratory and examination, and 16.3% for therapy. LOHS, hospital level, and pulmonary infection were key determinants of the hospital charges.

CONCLUSIONS

The proportion of medicine fees for the ischemic stroke inpatients showed a downward trend during the period from 2012 to 2015, but medicine fees still accounted for the largest percentage of hospital charges in China. LOHS emerged to be the main determinant of the cost. Decreasing medicine fees and LOHS might be strategies to decrease hospital charges and reduce economic burden of stroke in China.

摘要

背景

本研究旨在分析北京地区急性缺血性脑卒中患者的住院费用,并确定与住院费用相关的因素。

方法

本研究收集了 2012 年 3 月 1 日至 2015 年 2 月 28 日期间北京 121 家医院以国际疾病分类第 10 次修订版(ICD-10)为主要诊断的缺血性脑卒中住院患者的病历。研究了不同医院级别(二级医院和三级医院)和类型(西医医院和中医医院)的住院费用分布特征。采用线性回归分析检验医院费用与影响总住院费用的因素之间的关系。

结果

共有 158781 例缺血性脑卒中患者住院,其中 63.1%为男性,平均年龄为 67.7±12.4 岁,中位住院时间(LOHS)为 13.5 天(9.9-18.1 天)。中位住院费用为 2112 美元(1436-3147 美元)。其中,药物费用占 46.7%,检验检查费用占 21.1%,治疗费用占 16.3%。LOHS、医院级别和肺部感染是住院费用的主要决定因素。

结论

2012 年至 2015 年期间,缺血性脑卒中患者的药物费用比例呈下降趋势,但药物费用仍占中国住院费用的最大比例。LOHS 是费用的主要决定因素。降低药物费用和 LOHS 可能是降低医院费用和减轻中国卒中经济负担的策略。

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