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目的研究我国部分地区不同级别医院新生儿窒息的住院费用,并探讨其影响因素,为进一步开展新生儿复苏项目,减轻新生儿窒息疾病经济负担提供建议。方法选择年分娩量较大(>1000活产/年)的省级医院2所、地市级医院2所、县级医院2所。查找2009年和2010年两年间在上述医院发生的全部新生儿出生窒息病例,从医疗机构2009年和2010年所有符合入选标准的出生窒息住院病例记录中,收集有关出生窒息诊治费用的资料,包括诊断、急救、住院、药品、手术等直接医疗费用进行回顾性调查。结果共调查891例,住院费用均数为5171.8元,各省之间、各级别医院住院费用间差异均有显著性。新生儿出生后1 min Apgar评分、住院天数、不同省份、不同级别医院以及病人来源为住院费用的相关因素。结论加强新生儿复苏技术培训,减少重度窒息的发生,完善疾病诊疗规范,可减少新生儿窒息病例的医疗费用,减轻患儿家庭的经济负担。
Objective To study the cost of neonatal asphyxia in hospitals of different levels in some areas of China and to explore the influencing factors, so as to provide suggestions for further carrying out neonatal resuscitation projects and alleviating the economic burden of neonatal asphyxia. Methods Two provincial-level hospitals, two prefecture-level hospitals and two county-level hospitals were selected with larger annual deliveries (> 1000 live births / year). Finding all neonatal asphyxia cases occurring in these hospitals in 2009 and 2010 and collecting information on the costs of diagnosis and management of birth asphyxia in all inpatient records of asphyxiated children born in 2009 and 2010 that meet the inclusion criteria Diagnosis, first aid, hospitalization, medicine, surgery and other direct medical costs for a retrospective survey. Results A total of 891 cases were investigated, and the average cost of hospitalization was 5171.8 yuan. There was significant difference in hospitalization costs among the provinces and among all levels of hospitals. Apgar score at 1 min after birth, days of hospitalization, hospitals in different provinces, different levels, and sources of patients were related factors for hospitalization costs. Conclusion Strengthening the training of neonatal resuscitation techniques to reduce the incidence of severe asphyxia and improve the diagnosis and treatment of diseases can reduce the medical costs of neonatal asphyxia cases and reduce the financial burden on families with children.