论文部分内容阅读
目的描述T2DM及微血管并发症的入院特点及住院费用构成,分析住院费用的影响因素。方法收集4家综合医院1年出院第一诊断为T2DM的住院病历,构建一般线性模型(GLM)进行费用分析。结果收集病例1726例,分为4大类19个亚类,平均入院年龄60岁,住院时间中位数12 d,住院费用中位数7122元,医疗服务费用、诊断费用、西药费用分别占23%、22%、45%。GLM结果表明,住院时间对不同T2DM亚组的住院费用影响表现不同,与T2DM无并发症比较,住院时间对视网膜病变、多发神经病变的住院费用影响差别不大(β=21.7,97.4;P=0.67,0.02);而对肾小球硬化症、多发性微血管病变与伴有血糖控制不佳的影响则较大(β=172.7、240.9、163.5,P<0.01)。结论对不同入院年龄、住院时间、住院费用的T2DM并发症应进行分类管理。
Objective To describe the characteristics of admission and cost of hospitalization for T2DM and microvascular complications and analyze the influencing factors of hospitalization costs. Methods The hospital records of the first diagnosis of T2DM discharged from one hospital in 4 general hospitals and the general linear model (GLM) were collected for cost analysis. Results A total of 1726 cases were collected and divided into 4 major categories and 19 subtypes. The average age of admission was 60 years. The median length of hospitalization was 12 days. The median hospitalization cost was 7122 yuan. The costs of medical services, diagnoses and western medicines accounted for 23 %, 22%, 45%. GLM results showed that hospitalization time had different effects on hospitalization costs in different subgroups of T2DM. Compared with non-complication of T2DM, hospitalization time had little effect on hospitalization expense of retinopathy and multiple neuropathy (β = 21.7,97.4; P = 0.67,0.02), while the effects of glomerulosclerosis, multiple microangiopathy and poor blood glucose control were greater (β = 172.7, 240.9, 163.5, P <0.01). Conclusions T2DM complications of different admission ages, hospitalization days and hospitalization expenses should be classified and managed.