| 张明明,葛乃航.基于慢性创面住院费用的卫生经济学分析[J].安徽医药,2024,28(9):1890-1894. |
| 基于慢性创面住院费用的卫生经济学分析 |
| Health economics analysis based on the hospitalization costs of chronic wounds |
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| DOI：10.3969/j.issn.1009-6469.2024.09.042 |
| 中文关键词: 费用，医疗 住院病人 慢性创面 临床特征 卫生经济学 回顾性研究 |
| 英文关键词: Fees, medical Hospitalized patients Chronic wounds Clinical characteristics Health economics Retrospective analysis |
| 基金项目: |
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| 摘要点击次数: 776 |
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| 中文摘要: |
| 目的调查慢性创面病人的临床特征，进行回顾性卫生经济学分析。方法回顾性分析 2016年 1月至 2020年 12月在盐城市第一人民医院接诊的 875例慢性创面住院病人的一般资料、创面信息、治疗信息、科室分布及卫生经济学信息。用 SPSS 25.0行数据分析。结果慢性创面病人中男性占比高于女性， 61~80岁病人最多，且常合并基础疾病。创面病原微生物监测中革兰阴性菌检出率最高。主要创面类型为糖尿病性创面、创伤性创面和静脉性创面。不同创面类型病人的治疗有效率及住院时间和住院费用比较，均差异有统计学意义( P<0.05)。多数病人( 68.6%)采取手术治疗，手术治疗的治疗有效率(95.2%)、住院时间 17(10，33)d、住院费用 21 764(12 352，45 437)元均高于非手术治疗［67.3%、9(5，17)d、8 072(4 875，11 875)元］(P<0.05)。不同手术方式中轴型皮瓣的住院时间 41(26，65)d、住院费用 52 902(36 828，122 521)元均高于随意型皮瓣［28(17，41)d、32 605(17 829，51 835)元］(P<0.05)。病人多分布在烧伤整形科、普外科、骨科等科室，不同科室病人的住院时间和住院费用比较，均差异有统计学意义( P<0.05)。医保病人自付费用 5 450(2 781，9 383)元低于非医保病人自付费用 18 391(8 723，74 627)元。医保病人的住院时间 14(8，22)d、住院费用 14 177(9 018，28 396)元均低于非医保病人［16(8，46)d、18 391(8 723，74 627)元］(P<0.05)。结论慢性创面中创伤性创面住院费用较高。相比非手术治疗，手术治疗住院费用高但治疗有效率高。医保病人自付费用较低，参加医保有利于减轻病人的经济负担。 |
| 英文摘要: |
| Objective To investigate the clinical characteristics of patients with chronic wounds and to conduct a retrospectivehealth economics analysis.Methods A retrospective analysis of the general data, trauma information, treatment information, depart-mental distribution and health economic information of 875 chronic trauma inpatients seen at the First People's Hospital of YanchengCity from January 2016 to December 2020 was performed. The data were statistically analyzed using SPSS 25.0.Results Chronic wounds were more prevalent in males than in females with the highest number of patients aged 61-80 often having underlying disease. The highest detection rate of gram-negative bacteria was found in the microbiologic surveillance of trauma pathogens. The main typesof wounds were diabetic wounds, traumatic wounds, and venous wounds. A comparison of the treatment efficiency, and hospitalizationtime and hospitalization cost of patients with different wound types revealed statistically significant differences (P<0.05). Most patients(68.6%) were treated with surgery, which had greater treatment efficacy (95.2%), a hospitalization time of 17 (10, 33) days, and a hos-pitalization cost of 21 764 (12 352, 45 437) yuan than the nonsurgical treatment [67.3%, 9 (5, 17) days, and 8 072 (4 875, 11 875) yu-an] (P<0.05). The hospitalization time of 41 (26, 65) days and hospitalization cost of 52 902 (36 828, 122 521) yuan were greater foraxial flaps than for random flaps [28 (17, 41) days, 32 605 (17 829, 51 835) yuan] among the different surgical modalities (P < 0.05).The patients were mostly distributed in the burns and plastic surgery, general surgery and orthopedic departments, and the differencesin the hospitalization time and hospitalization cost of the patients from different departments were statistically significant (P<0.05). The out-of-pocket cost of 5 450 (2 781, 9 383) yuan for the medically insured patients was lower than the out-of-pocket cost of 18 391(8 723, 74 627) yuan for the nonmedically insured patients. The length of stay of 14 (8, 22) d and the hospitalization cost of 14 177 (9,018, 28 396) yuan were lower for the medically insured patients than for the nonmedically insured patients [16 (8, 46) d, 18 391 (8723, 74 627) yuan] (P<0.05).Conclusions Hospitalization costs were greater for traumatic wounds than for chronic wounds. Com- pared with non-surgical treatment, surgical treatment has high hospitalization costs but high treatment efficiency. The out-of-pocketcosts were lower for medically insured patients, and enrollment in medical insurance was beneficial for reducing the financial burdenof patients. |
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