【摘要】：目的:以北京市37家三級(jí)醫(yī)院冠心病患者為研究對(duì)象,深入了解冠心病費(fèi)用現(xiàn)狀以及影響因素,探討費(fèi)用合理區(qū)間,為疾病費(fèi)用管理和控制提供參考。方法:采用方差分析、多元線性回歸、決策樹(shù)等方法。結(jié)果:(1)冠心病門(mén)診和住院患者的平均年齡分別為65.23歲和67.47歲。(2)冠心病門(mén)診患者次均費(fèi)用為598.60元,其中藥品費(fèi)用占比為85.21%。(3)冠心病患者平均住院費(fèi)用為25,422.06元,平均住院床日為8.35床日,費(fèi)用主要以衛(wèi)生材料費(fèi)和藥品費(fèi)為主,合計(jì)占比超過(guò)70%。(4)住院天數(shù)、患者年齡、就診醫(yī)院、合并癥以及并發(fā)癥數(shù)目、性別是影響急性心肌梗死患者住院費(fèi)用的主要因素。(5)以急性心肌梗死為例,構(gòu)建決策樹(shù)分組模型,最終分為13個(gè)病例組,各組間費(fèi)用差異具有統(tǒng)計(jì)學(xué)意義。結(jié)論:加大冠心病防治力度,控制冠心病年輕化趨勢(shì)。藥品和衛(wèi)生材料費(fèi)是冠心病患者疾病負(fù)擔(dān)的主要來(lái)源。需要通過(guò)縮短住院天數(shù),重視疾病預(yù)防,推進(jìn)臨床路徑管理等手段控制冠心病費(fèi)用的過(guò)快增長(zhǎng)。
[Abstract]:Objective: to investigate the current situation and influencing factors of coronary heart disease (CHD) in 37 tertiary hospitals in Beijing, to explore the reasonable cost range, and to provide reference for disease cost management and control. Methods: ANOVA, multiple linear regression and decision tree were used. Results: (1) the average age of outpatients and inpatients were 65.23 years old and 67.47 years old respectively. (2) the average cost of outpatients with coronary heart disease was 598.60 yuan, of which the proportion of drug cost was 85.21 yuan. (3) the average hospitalization cost of patients with coronary heart disease was 25422.06 yuan. The average hospitalization bed days were 8.35 bed days, and the expenses were mainly health materials and drugs, accounting for more than 70.1% of the total. (4) the days of hospitalization, the age of patients, the number of hospitals, the number of complications, and the number of complications. Sex is the main factor affecting the hospitalization cost of patients with acute myocardial infarction. (5) taking acute myocardial infarction as an example, a decision tree grouping model was constructed and finally divided into 13 case groups. Conclusion: strengthen the prevention and treatment of coronary heart disease, control the trend of younger coronary heart disease. The cost of medicine and health materials is the main source of disease burden in patients with coronary heart disease. The cost of coronary heart disease should be controlled by shortening hospitalization days, paying attention to disease prevention and promoting clinical path management.
【作者單位】： 北京中醫(yī)藥大學(xué)基礎(chǔ)醫(yī)學(xué)院;中國(guó)中醫(yī)科學(xué)院廣安門(mén)醫(yī)院;北京中醫(yī)藥大學(xué)管理學(xué)院;
【基金】：國(guó)家中醫(yī)藥管理局重點(diǎn)學(xué)科“中醫(yī)藥管理學(xué)”資助項(xiàng)目(2013-ZDXKKF-17)
【分類(lèi)號(hào)】：R197.323;R541.4

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