肺部感染患者住院费用及病死率的影响因素分析

nfluencing factors of hospitalization cost and mortality of patients with pulmonary infection

摘要:

目的调查广州市某三甲医院肺部感染患者住院费用、住院日数及病死情况，并探讨其影响因素，为医院进一步采取针对性的感染控制措施提供科学依据。方法收集该院2011年1月—2012年12月住院诊断为肺部感染患者的病案首页资料，采用单因素分析、多元线性回归和logistic回归法比较不同类型肺部感染患者住院费用、平均住院日和预后的差异及其影响因素。结果10 431例肺部感染患者住院费用平均为（29 081.95±38 682.92）元，中位数为16 085.25元；住院日平均为（15.93±20.54）d，中位数为13.00 d；共有828例患者经治疗无效后死亡，病死率7.94%。不同性别、年龄、付款方式、入院病情、肺部感染类型以及手术与否的肺部感染患者住院费用和住院日数差异均有统计学意义（均P＜0.05），不同年龄、付款方式、入院病情、肺部感染类型以及手术与否的肺部感染患者死亡率差异也有统计学意义（P＜0.05）；影响肺部感染患者住院费用从大到小的因素依次为住院日数、是否手术、付款方式（公费医疗）、肺部感染类型（HAP）、年龄、性别等，影响其住院日数的因素从大到小依次为是否手术、肺部感染类型（HAP）等，造成其死亡的危险因素有入院情况、肺部感染类型以及是否手术等。结论控制医院肺部感染，对有效控制住院费用，缩短平均住院日，提高患者生存率具有重要作用。

Abstract:

ObjectiveTo investigate the hospitalization cost, length of stay in hospital, and mortality in patients with pulmonary infection in a hospital, and evaluate the influencing factors, so as to  provide scientific basis for making targeted infection control measures. MethodsMedical records of patients with pulmonary infection  between January 2011 and December 2012 were collected, the difference and influencing factors of hospitalization cost, average length of stay, and prognosis among patients with different types of pulmonary infection were compared and analyzed by univariate analysis, multiple linear regression analysis, and logistic regression analysis.  ResultsOf  10 431 patients with  pulmonary infection, the average hospitalization cost was （29 081.95±38 682.92）yuan(RMB), the median cost was 16 085.25 yuan(RMB), and the average length of stay was （15.93±20.54）d, the median was 13.00 d, a  total of 828 patients died due to invalid treatment,mortality was 7.94%. There were significant differences in hospitalization cost, average length of stay  among patients with different genders, ages, modes of payment, admission status of illness, types of pulmonary infection, and operation or not (all P<0.05), and the differences in mortality were also  significant among patients of above characteristics except gender(all P<0.05). Influencing factors for hospitalization cost were as follows: length of stay, whether or not operated, modes of payment, types of pulmonary infection(healthcareassociated pneumonia, HAP), age,  gender, and so on, influencing factors for  length of stay were whether or not operated and types of pulmonary infection, factors leading to death were admission condition, types of pulmonary infection(HAP),and whether or not operated, and so on. ConclusionControl of healthcareassociated pulmonary infection is important for controlling hospitalization cost, shortening average length of stay, and improving survival rate of patients.