本文選題：腦卒中 + 住院費用　； 參考：《中國衛(wèi)生政策研究》2016年05期

【摘要】：目的:揭示以醫(yī)保類型和職業(yè)為代表的社會背景因素對腦卒中患者住院費用差異的影響,以及這種差異對患者預后的影響。方法:對2011—2014年分布在不同省份的5家三甲醫(yī)院共計18 879例腦卒中住院患者的住院費用和院內死亡情況進行描述性分析,并通過多元線性回歸和logistic回歸分別分析住院費用和預后的影響因素。結果:在控制了患者人口社會學特征、住院過程和臨床特征的前提下,公費醫(yī)療患者的費用比自費患者高19.7%(P0.001),退休人群和公務員、企事業(yè)單位人員的住院費用分別比農民高4.2%(P0.001)、2.9%(P=0.049);公費醫(yī)療患者院內死亡的風險是自費患者的4.901倍(95%CI 1.652~14.537),退休人群院內死亡風險比農民高2.145倍(95%CI 1.287~3.573)。結論:由于社會背景因素的影響,部分患者花費了更多的住院費用,但并不是花費的住院費用越多,腦卒中的預后就越好。
[Abstract]:Objective: to explore the influence of social background factors, such as the type of medical insurance and occupation, on the difference of hospitalization expenses and the prognosis of stroke patients. Methods: the hospital expenses and hospital mortality of 18 879 stroke inpatients in 5 third Class A hospitals in different provinces from 2011 to 2014 were analyzed. Multivariate linear regression and logistic regression were used to analyze the influencing factors of hospitalization cost and prognosis respectively. Results: under the premise of controlling the sociological characteristics of patient's population, hospitalization process and clinical characteristics, the cost of public medical treatment patients was 19.7g / P 0.001 higher than that of self-funded patients, and the retired population and civil servants, The hospital expenses of the personnel of enterprises and institutions were 4.2% higher than that of the peasants, respectively. The risk of death in the hospital of the patients with public medical treatment was 4.901 times that of the patients at their own expense, and the risk of death among the retired people was 2.145 times higher than that of the peasants, and the risk of death in the hospitals was 2.145 times higher than that of the farmers. The risk of death in the hospitals of the patients with public medical treatment was 4.901 times that of the patients at their own expense, and the risk of death among the retired people was 2.145 times higher than that of the peasants. Conclusion: because of the influence of social background, some patients spend more hospital expenses, but not the higher the cost of hospitalization, the better the prognosis of stroke.
【作者單位】： 北京協(xié)和醫(yī)學院公共衛(wèi)生學院;
【基金】：國家自然科學基金(7151101034)
【分類號】：R743.3;R197.323

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