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目的通过糖尿病并发下肢周围神经血管病变患者非手术治疗的相关费用的调查,探索在一级医院对该病治疗的最好疗效和最低费用。方法分析某一级医院2005—2011年500例住院并发下肢周围神经血管病变糖尿病患者的非手术治疗相关费用。结果①平均每人住院费4 555.37元,其各项平均费用为西药1 669.38元、中药1 313.41元、检验800.78元、治疗193.69元、床位167.98元、检查198.72元、护理68.32元、诊查63.29元及材料79.87元。②病程长短、并发症严重程度等均与患者非手术治疗所花费用成正比:病程5～10 a以及>10 a的患者所花费的西药费、治疗费、床位费以及总费用均高于病程<5 a的患者;病程>10年的患者所花费的中草药费、诊查费和护理费高于病程<5 a以及5～10 a的患者。2种和3种及以上并发症的患者所花费的西药费、中成药费、检验费、检查费、床位费、诊查费以及总费用均高于无并发症或只有1种并发症的患者。病理二期的患者所花费的西药费、检查费、治疗费、床位费、诊查费以及总费用均高于病理一期的患者。3种和3种以上并发症及动脉病变的患者所花费的检查费和治疗费高于1及2种动脉病变的患者。结论某一级医院采用中西结合特色治疗糖尿病并发下肢周围神经血管病,可使该病获得了最佳治疗效果和最少不良反应,且住院费用最低,为国家、医保、个人节减医药费用开支探索出新的途径。
Objective To investigate the best curative effect and the lowest cost in the treatment of this disease in the first grade hospitals through the investigation of the related costs of non-surgical treatment of diabetic peripheral neurovascular disease. Methods A total of 500 hospitalized patients with peripheral neurovascular disease in the lower extremities from 2005 to 2011 were analyzed for non-surgical treatment-related costs. Results ① The average hospitalization cost per person was 4 555.37 yuan, with an average cost of 1 669.38 yuan for western medicine, 1 313.41 yuan for traditional Chinese medicine, 800.78 yuan for Chinese medicine, 193.69 yuan for treatment, 167.98 yuan for bed, 198.72 yuan for examination, 68.32 yuan for nursing care, 63.29 for diagnosis Yuan and material 79.87 yuan. ② duration of the disease, the severity of the complications are directly proportional to the cost of non-surgical treatment of patients: the course of 5 ~ 10 a and> 10 a patients spent Western medicine costs, treatment costs, bed costs and the total cost were higher than the duration Patients who were less than 5 years and those who had a course of more than 10 years spent more time on herbal medicine, medical examination and nursing care than those who were less than 5 years and 5 to 10 years. Western medicine, Chinese patent, examination fee, examination fee, bed fee, examination fee and total cost spent on patients with 2 types and 3 or more complications were higher than those without complications or with only 1 type of complication . Western patients spent two pathological costs, examination fees, treatment costs, bed fees, examination fees and the total cost were higher than the pathological stage of patients. 3 and more than three complications and arterial disease patients spent more examination fees and treatment costs than 1 and 2 kinds of arterial disease patients. Conclusion A certain level of hospital using Western characteristics combined with diabetes mellitus and peripheral neurovascular disease of the lower extremities, the disease can be the best treatment and least adverse reactions, and the lowest hospital costs for the national health insurance, personal medical expenses to explore the cost savings New way.