帕金森病住院费用相关因素分析
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南京医科大学附属第一临床医学院

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医疗服务价格改革后医保基金运行绩效跟踪研究


Factors for hospitalization costs of Parkinson’s disease
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    摘要:

    目的:分析并探讨帕金森病患者住院费用的影响因素。方法:选取2009年1月至2015年12月在南京医科大学第一附属医院帕金森病住院患者320例,其中接受脑深部电刺激器(DBS)置入手术患者37例,内科治疗患者283例,根据H Y(Holehn Yahr)分级、住院时间以及合并感染情况等对住院费用进行分析比较。结果:非手术帕金森病患者住院费用与住院天数呈显著线性相关(r=0.685,P<0.001);帕金森患者年龄、性别、合并感染情况及H Y分级与总住院费用显著相关;性别、合并感染情况及H Y分级与日均住院费用显著相关;而年龄、住院年份、合并感染情况及H Y分级与住院天数显著相关。晚期组(IV~V级)合并肺部感染率显著高于早期组(I~II级)及中期组(III级)患者(χ2= 10.47,P =0.005)。接受DBS手术患者住院费用较晚期内科治疗组显著增高(t=7.74,P <0.001)。结论:非手术帕金森病住院费用与患者基线特征及临床分期等多种因素相关,随着H Y分级增加,住院时间及总住院费用显著增加。晚期帕金森病患者住院费用显著高于其它各期患者。

    Abstract:

    Objective:To investigate the influence factors for the hospitalization costs of Parkinson’s disease (PD). Methods:The 320 patients with PD at the First Affiliated Hospital of Nanjing Medical University were recruited from January 2009 to December 2015. Thirty-seven patients accepted deep brain stimulation (DBS) operation and 283 received other medical treatment. Patients were categorized to five stages according to Holehn Yahr (H Y) standard. The hospitalization costs were compared along with different stage of PD, length of hospitalization and concurrent infection. Results:Among the nonoperative patients with PD, there was a significant linear correlation between the hospitalization costs and length of stay (r=0.685,P<0.001).The age, sex, concurrent infection and different stage were significantly correlated with the hospitalization costs as well (P<0.05). The sex, concurrent infection and stage were also significantly correlated with the average hospitalization costs. And the age, hospitalization year, concurrent infection and stage were significantly correlated with the length of stay. The rate of concurrent pulmonary infection was positively correlated with patient’s stage patients (χ2= 10.47,P =0.005). The hospitalization costs were significantly higher in the operation group than that of non-operative group (t=7.74,P <0.001). Conclusion:The hospitalization costs and length of stay of the nonoperative PD patients relate to the baseline characteristics including age, gender, concurrent infection and patient’s stage.

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  • 收稿日期:2017-12-30
  • 最后修改日期:2018-04-22
  • 录用日期:2018-08-30
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