Analysis Of The Trends And Influencing Factors Of Hospitalization Expenses Of Patients With Diabetic Foot

Objective:retrospectively analyze the change trend of hospitalization expenses, the proportion of all the costs,the influencing factors of hospitalization expenses of patients with diabetic foot of 2002 to 2013,to provide the basis for further large-scale epidemiological studies, founding in a timely manner to diabetic foot high risk population, effective prevention and early treatment of diabetic foot,improving the life quality of patients so as to reduce diabetic foot related medical expenditure.In this way, exploring a new way for country, health care and individual to reduce the medical expenses.Methods: 1 Selecting patients with diabetic foot who were in hospitalization in metabolic disease hospital of Medical University Of Tianjin Department during January,2002 to December,2013 on the basis of selection and exclusion criteria, a total of 1575 patients were included in the study.2 Divide all the patients into A,B, C, D 4 groups for an average in every three years,and compare the trend of the change of the hospitalization expenses between the 4 groups and the constitution of the divided cost.3 Group the general condition, local conditions of foot, complications and comorbidities situation and operation situation of all the patients with diabetic foot, comparing the differences of hospitalization cost between groups in each item after grouping.4 Multiple linear regression analysis was used to further explore the factors affecting hospitalization expenses and days.5 Test the correlation of hospitalization expenses and days.Results: 1.Of all the 1575 patients with 992 males and 583 females, age ranges from15 to 91 years,the mean age 66 ±11 years and the course of DM ranges from a half year to 40 years,the median time of 11.5 years and the course of DF ranges from 1 to 417 weeks,the median time of 5 weeks. 2. The costs of A, B, C, D four groups are rising in the trend, with Group D the fastest growing and the number of hospital days has some fluctuations, but in downward trend on the whole.3.The drug with a slow growth is the major part of total costs. Inspection costs,treatment costs, operation costs, disposable materials costs and their proportions in the total fee are all on the rise. Medical services and nursing fee have some fluctuations, but in a downward trend in general,consistent with the hospital days.Other fee is slightly rising. Significant differences of the cost are between the four groups(P<0.05) except general medical services.4.There are statistically significant differences in the hospitalization costs of 12 variables of age, duration of diabetes, ulcer duration, Hb A1 c, Wagner classification,ABI, the number of pathogenic bacteria,diabetic retinopathy, nephropathy, hypertension, the number of complications and the operation mode,with significant differences in the days of 11 variables of age, Hb A1 c, Wagner classification,ABI, the number of pathogenic bacteria,diabetic retinopathy, nephropathy, cerebrovascular disease,dyslipidemia, the number of complications and the operation mode in single factor analysis.5 Age, hospitalization days, ulcer duration, ABI, Wagner classification, pathogenic bacteria number, hypertension, the number of complications and operation way finally enter the regression model of hospitalization expenses,and age, Hb A1 c,ABI, wagner classification, the number of complications and operation way entering the model of hospitalization days.6.Hospitalization expenses and days were positively related because of the correlation test whose spearman coefficient is 0.856 with P=0. 000<0. 05 which means the results are significant.Conclusion: The hospitalization cost with a rising trend of diabetic foot is great, with drugs accounting for the most,and it varies with different clinical features.The influencing factors of the costs conclude age, hospitalization days, ulcer duration, Wagner classification, ABI, the number of pathogenic bacteria,hypertension, the number of complications and operation mode,while as to days,age, Hb A1 c, Wagner classification, ABI,the number of complications and operation mode are. Hospital costs and length of hospital stay are correlation which means all the above factors have influence on the expenses. Facing all these,we should strengthen the publicity and education of foot disease, inspect the risk factors of diabetic foot lesions regularly,and thus correct them timely to significantly reduce the incidence of diabetic foot and the relevant cost.