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在近期人口趋势的压力下,对波兰一家大型临床医院治疗老年患者的成本进行分析。

An analysis of the costs of treating aged patients in a large clinical hospital in Poland under the pressure of recent demographic trends.

作者信息

Pobrotyn Piotr, Susło Robert, Witczak Izabela T, Rypicz Łukasz, Drobnik Jarosław

机构信息

Management, University Clinical Hospital, Wroclaw, Poland.

Gerontology Unit, Public Health Department, Health Sciences Faculty, Wroclaw Medical University, Wroclaw, Poland.

出版信息

Arch Med Sci. 2019 Jan 11;16(3):666-671. doi: 10.5114/aoms.2018.81132. eCollection 2020.

Abstract

INTRODUCTION

The aging of modern societies increases the general healthcare burden due to the growing demand for inpatient services, which lack adequate financing.

MATERIAL AND METHODS

Data concerning the costs of 312,250 hospitalizations at University Clinical Hospital in Wrocław, Poland in the years 2012-2015 were analyzed according to the age of the patients: below 65 years and 65 years and older, with subgroups (65-74, 75-84 and 85 years and older).

RESULTS

The mean length of stay (LOS) differed significantly for patients below 65 years and for patients 65 years old or older (3.5 vs. 4.7 person-days); over the 4 years covered by our data, these increased by 0.4 person-days, mostly among patients 85 years and older (by 0.7 person-days). The mean direct cost of hospitalization differed significantly for patients below 65 years and those 65 years or older (PLN 4,907.12 vs. PLN 6,357.15). The mean cost of laboratory tests and radiologic diagnostics was significantly higher among those in the 65+ group, and the difference had a rising trend. The differences between age groups in cost-related hospitalization characteristics and direct hospitalization costs that have been suggested by the medical literature have also been confirmed in Poland.

CONCLUSIONS

The mean hospitalization costs of patients aged 65 years and older in Poland are higher than for younger patients due to longer LOS and more complex and expensive treatment, especially laboratory and radiologic diagnostics, which is increasingly common in the oldest age groups. This demands an urgent systemic solution, especially in terms of adjusted financing of elderly patients' hospital treatment.

摘要

引言

现代社会的老龄化因住院服务需求不断增长而增加了总体医疗负担,而住院服务缺乏足够的资金支持。

材料与方法

根据患者年龄(65岁以下和65岁及以上),对2012 - 2015年波兰弗罗茨瓦夫大学临床医院312,250例住院费用数据进行分析,65岁及以上患者再分为亚组(65 - 74岁、75 - 84岁和85岁及以上)。

结果

65岁以下患者与65岁及以上患者的平均住院天数(LOS)差异显著(3.5对4.7人日);在我们数据涵盖的4年中,这些天数增加了0.4人日,主要是85岁及以上患者(增加了0.7人日)。65岁以下患者与65岁及以上患者的平均住院直接费用差异显著(4,907.12波兰兹罗提对6,357.15波兰兹罗提)。65岁及以上组患者的实验室检查和放射诊断平均费用显著更高,且差异呈上升趋势。医学文献中提出的不同年龄组在与费用相关的住院特征和住院直接费用方面的差异在波兰也得到了证实。

结论

由于住院天数更长以及治疗更复杂、费用更高,特别是实验室检查和放射诊断,波兰65岁及以上患者的平均住院费用高于年轻患者,这在最年长年龄组中越来越常见。这需要紧急的系统性解决方案,特别是在调整老年患者住院治疗资金方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5192/7212232/716653b2399e/AMS-16-3-34610-g001.jpg

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