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目的调查和分析糖尿病足医疗费用及其影响因素。方法前瞻性地对全国14家三级甲等医院的2004年全年门诊和住院糖尿病足患者的足局部情况进行 Wagner 分级、Texas 分期和溃疡性质分析及住院天数、医疗费用等调查。结果 573例患者的平均费用(14906±7072)元;其中药品费占56%、检查费占19%;患者职业、糖尿病病程对住院天数及费用有显著影响,合并糖尿病肾病患者住院费用显著增加,随着溃疡深度的加重,住院天数及费用明显增加;随足溃疡数量增加,住院天数无明显增加,但住院费用显著增加;合并感染及缺血的足病患者住院天数及住院费用均明显增加;缺血性溃疡较神经性和混合性的住院天数及住院费用均明显增加;合并坏疽足患者住院天数延长、住院费用增加。结论糖尿病足医疗费用高。糖尿病足医疗费用与合并肾病、溃疡、缺血和感染的严重程度明显正相关。
Objective To investigate and analyze the medical expenses of diabetic foot and its influencing factors. Methods Wagner classification, Texas staging and ulcer property analysis, hospitalization days and medical expenses were investigated prospectively in 2004 outpatients and inpatients with diabetic foot in 2004 Grade A hospitals nationwide. Results The average cost of 573 patients (14906 ± 7072) yuan; of which 56% of drug costs, examination fees accounted for 19%; patient occupations, diabetes duration of hospitalization days and costs have a significant effect, with diabetic nephropathy patients with hospital costs increased significantly, As the ulcer depth aggravated, the number of hospital days and costs increased significantly. With the increase of the number of ulcer, there was no significant increase in the days of hospitalization, but the cost of hospitalization increased significantly. The days of hospitalization and cost of hospitalization of patients with foot infection complicated by ischemia and ischemia increased obviously. Ischemic ulcer neurotic and mixed hospital days and hospital costs were significantly increased; combined gangrene foot hospitalization days prolonged, hospitalization costs increased. Conclusion Diabetic foot medical costs high. Diabetic foot medical costs and nephrosis, ulcers, ischemia and the severity of infection was significantly positively correlated.