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| 投稿时间： 2015-10-08 最后修改时间： 2016-04-01 摘要点击次数: 2411 全文下载次数: 9 |
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| 引用本文：曹英南, 关天嘉, 李晋磊,等.脑卒中患者住院费用及预后影响因素研究[J].中国卫生政策研究,2016,9(5):54-60 |
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| 曹英南, 关天嘉, 李晋磊, 曲翌敏, 王班, 刘远立 |
| 北京协和医学院公共卫生学院 北京 100730 |
| 基金项目:国家自然科学基金(7151101034) |
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| | 摘要:目的:揭示以医保类型和职业为代表的社会背景因素对脑卒中患者住院费用差异的影响,以及这种差异对患者预后的影响。方法:对2011—2014年分布在不同省份的5家三甲医院共计18 879例脑卒中住院患者的住院费用和院内死亡情况进行描述性分析,并通过多元线性回归和logistic回归分别分析住院费用和预后的影响因素。结果:在控制了患者人口社会学特征、住院过程和临床特征的前提下,公费医疗患者的费用比自费患者高19.7%(P < 0.001),退休人群和公务员、企事业单位人员的住院费用分别比农民高4.2%(P < 0.001)、2.9%(P=0.049);公费医疗患者院内死亡的风险是自费患者的4.901倍(95% CI 1.652~14.537),退休人群院内死亡风险比农民高2.145倍(95%CI 1.287～3.573)。结论:由于社会背景因素的影响,部分患者花费了更多的住院费用,但并不是花费的住院费用越多,脑卒中的预后就越好。 | |
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关键词:脑卒中 住院费用 医疗保险
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| Analysis on the hospitalization costs differences and its effects on health outcome among the stroke patients |
| CAO Ying-nan, GUAN Tian-jia, LI Jin-lei, QU Yi-min, WANG Ban, LIU Yuan-li |
| School of Public Health, Peking Union Medical College, Beijing 100730, China |
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| | Abstract:Objective: The paper is designed to reveal differences in stroke patients' hospitalization costs created by different socioeconomic factors, health insurance and occupational background, and analyze those differences on health outcome. Methods: 18879 cases of hospitalized patients with stroke in five tertiary hospitals from four provinces from 2011 to 2014 were included in the database. Descriptive statistics was used to describe patients' hospitalization costs and health outcome. Multiple linear regression model and logistic regression were used to evaluate the impact of insurance and occupation. Results: After controlling for patients' social characteristics, health risks, premise during hospitalization process and clinical characteristics of patients with free healthcare costs, the socialized medicine was charged 19.7% higher than the private ones (P<0.001), the retired people and civil servants were charged 4.2% (P<0.001) and 2.9% (P=0.049) more than farmers. The socialized medicine was also associated with health outcome. The risk of death in patients with free medical care is (OR=4.901) compared with private patients (95%CI 1.652~14.537), and the retired people had increased risk of death compared with farmers (OR=2.145, 95%CI 1.287~3.573). Conclusions: Due to the impact of social background factors, some groups are found to have a higher level of expenses than their counterparts during hospitalization, but the more hospitalization costs are not spent the better the health outcome of stroke was achieved. | |
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