急性缺血性脑卒中住院患者成本与医疗资源利用

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摘要

目的:急性缺血性脑卒中的治疗费用是发展中国家关注的问题。本研究的目的是确定泰国急性缺血性卒中患者的成本和卫生保健资源利用。材料与方法:本研究为回顾性队列研究。作者回顾了急性缺血性脑卒中患者的电子病历数据。收集了有关资源利用和医疗保健费用(HCCs)的数据。描述了成本数据、患者特征和疾病严重程度。分析使用具有对数链接和伽马分布的广义线性回归模型进行。结果:28278例患者被诊断为缺血性脑卒中。每位患者的平均总费用为1,244.40(±594.81)美元。医疗设备是急性缺血性脑卒中患者最主要的费用。中重度脑卒中患者的hcc高于轻度脑卒中患者。多元广义线性模型显示,年龄、性别、大多数合并症和入院时的Barthel指数评分会影响急性缺血性卒中患者的总成本。结论:急性缺血性脑卒中患者的hcc与年龄、性别、某些合并症及入院时Barthel指数评分显著相关。由于中风的严重程度,hcc正在上升。关键词:急性缺血性卒中,医疗资源利用,医疗费用,泰国
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Costs and Healthcare Resource Utilization of Inpatients with Acute Ischemic Stroke
Objective: Acute ischemic stroke treatment costs are a concerning issue in developing countries. The objective of the present study was to determine cost and health-care resource utilization in patients with acute ischemic stroke in Thailand. Materials and Methods: The present study was a retrospective cohort study. The authors reviewed data from the electronic medical records of acute ischemic stroke patients. Data on resource utilization and healthcare costs (HCCs) were collected. Cost data, patient characteristics, and disease severity were described. Analyses were conducted using generalized linear regression models with a log-link and gamma distribution. Results: Two thousand two hundred seventy-eight patients had been diagnosed with ischemic stroke. The mean total costs per patient were 1,244.40 (±594.81) USD. Medical equipment was the most significant cost for acute ischemic stroke patients. Patients suffering from moderateto- severe stroke had higher HCCs than those suffering from minor stroke. Multivariate generalized linear modeling presented age, gender, most comorbidities, and the Barthel index score on admission to affect total cost in patients with acute ischemic stroke. Conclusion: HCCs in patients with acute ischemic stroke were significantly associated with age, gender, some comorbid conditions, and the Barthel index score at admission. HCCs are rising as a result of the severity of strokes. Keywords: Acute ischemic stroke, Healthcare resource utilization, Healthcare costs, Thailand
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