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基于路径分析的癫痫患者住院费用构成及影响因素

Composition and influencing factors of hospitalization expenses for epilepsy patients based on path analysis.

作者信息

Gong Jing, Li Nian, Wang Ying, Xie Wanzhen, Shi Leiyu, Liao Shengwu, Xia Oudong, Sun Gang

机构信息

West China Hospital of Stomatology Sichuan University, Chengdu, 610041, China.

West China Hospital of Sichuan University, Chengdu, 610041, China.

出版信息

Int J Equity Health. 2024 Aug 7;23(1):155. doi: 10.1186/s12939-024-02242-z.

Abstract

OBJECTIVE

This study aimed to understand the composition and influencing factors of epilepsy patients' hospitalization expenses, thus providing a reference for reducing the disease burden of epilepsy patients in low- and middle-income developing countries.

METHODS

A total of 4206 hospitalized cases of epilepsy from 2018 to 2020 were collected. Descriptive statistics were used to understand the patient cost composition, path analysis was used to understand the direct and indirect factors of hospitalization expenses.

RESULTS

From 2018 to 2020, the average hospitalization expenses for epilepsy patients was 4,299.93 RMB yuan, and the average length of stay was 2.47 days. The highest proportion of hospitalization expenses was diagnosis costs (> 50%), followed by comprehensive medical service costs and drug costs. In terms of the total effect coefficient, the major factors affecting the hospitalization expenses were length of stay (0.880), emergency admission(0.463), and the comorbidities and complications(> 0.250). Hospital length of stay, discharge mode(death) and number of hospitalizations(2 times) affect hospitalization expenses through direct effect. Long-term hospitalization (> 30 days), admission routes(emergency), the comorbidities and complications, presence of drug allergy, and age also affect hospitalization expenses through indirect effects.

CONCLUSION

Diagnosis costs and length of stay are important factors affecting the medical expenses of epilepsy inpatients. In general, the quality control of the hospital is good, but it still needs to standardize the diagnosis and treatment behavior of medical staff through the clinical path.

摘要

目的

本研究旨在了解癫痫患者住院费用的构成及影响因素,从而为减轻低收入和中等收入发展中国家癫痫患者的疾病负担提供参考。

方法

收集了2018年至2020年共4206例癫痫住院病例。采用描述性统计来了解患者费用构成,采用路径分析来了解住院费用的直接和间接影响因素。

结果

2018年至2020年,癫痫患者的平均住院费用为4299.93元人民币,平均住院天数为2.47天。住院费用占比最高的是诊断费用(>50%),其次是综合医疗服务费用和药品费用。就总效应系数而言,影响住院费用的主要因素是住院天数(0.880)、急诊入院(0.463)以及合并症和并发症(>0.250)。住院天数、出院方式(死亡)和住院次数(2次)通过直接效应影响住院费用。长期住院(>30天)、入院途径(急诊)、合并症和并发症、药物过敏情况以及年龄也通过间接效应影响住院费用。

结论

诊断费用和住院天数是影响癫痫住院患者医疗费用的重要因素。总体而言,医院的质量控制较好,但仍需通过临床路径规范医务人员的诊疗行为。

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