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

Part 1.Analysis the trends and influencing factors of hospitalization expenses with diabetic foot patientsChapter 1.Analysis the trends of hospitalization expenses with diabetic foot patientsObjective: To investigate and analysis the trends of hospitalization expenses and constitution with diabetic foot patients from 2009 to 2015.Methods: According to ICD-10 code and standard forms for retrospectively analyzed information of diabetic foot patients nearly seven years,including demographic characteristic,diabetic complications,classification of Wagner and medical costs at hospitals.As 2009 was the base value and adjust each year medical costs by consumer price index.Results: 901 cases(1146 admissions)with diabetic foot patients were used for analysis in seven years,and male were significantly higher than female(613 cases,756 admissions),and including 38 cases amputated diabetics.The total costs was increased and declined after adjusting by consumer price index and 27629.5 yuan in 2012 was the highest.The days in hospitalization was declined and there was a significant difference of more group to compared(x2=61.161,P<0.001),and each year compared with 2009,excepting 2010 and 2011 year,there was a significant difference(P<0.05),and the median days was 17 days in 2015 year.The average ages of patients was declined and there was a significant difference of patients ages more groups to compared(x2=45.892,P<0.001).The proportion of under the age of 60 patients with rising were 21.53%,38.20%,33.33%,45.03%,43.37%,46.80%,43.71% in each year,respectively.But the average age of less than 60 years old in each year and the average age were(62.59±12.53)years in 2015.Accounted for the most was drugs,more than 50% proportion in other years excepting 2011,and then check costs and treatment costs.The days in hospital and hospitalization expenses were highest of Wagner 4 and above patients in each year.The proportion of Wagner 3 and above patients were 72.22%,65.17%,73.19%,78.81%,66.87%,54.36%,61.59%,respectively.Most of patients have complications and in addition to PAD,the other complications proportion were increasing year by year,but there was no significant difference.Conclusion: The patients with diabetic foot were older,with more male,high hospitalization expenses and more diabetic complication proportion were increasing year by year.The drug with a major part of total costs,and then checking and treatment.It is suggested that the diagnosis and treatment should be optimized and multidisciplinary and multiple factors cooperation to therapy diabetic foot,and reforming of he medical and health system can reduce the economic burden of diabetic foot hospitalization expenses.Chapter 2.Analysis the influencing factors of hospitalization expenses with diabetic foot patientsObjective: To investigate and analysis the influencing factors of hospitalization expenses of diabetic foot patients in hospital.Methods: Using single factors and multiple stepwise regression analyzed the main influence factors of diabetic foot patients hospitalization expenses.Results: Single factors analysis the influenced hospitalization expenses that included the patients condition,Wagner classification,days in hospitalization,whether surgery,infection,the number of complications,whether rescue,diabetic duration.And multiple stepwise regression analysis showed that the days in hospitalization was greatest influenced factor and then Wagner classification.Conclusion: Hospitalization days,Wagner classification,whether surgery,the number of complications,patients condition finally enter the regression model of hospitalization expenses.The other four factors associated with clinical features excepting hospitalization days,and it is suggested that strengthen the prevention and control methods to therapy diabetic foot to reduce the diabetic foot hospitalization expenses.Part 2.The hospitalization expenses with diabetic foot patients of comparative studyObjective: It can be more intuitive response level the hospitalization expenses through comparing the difference of the patients with diabetic foot and cerebral infarction with diabetic.Methods: According to ICD-10 code and standard forms for retrospectively analyzed information of diabetic foot and cerebral infarction with diabetic patients at the same period,including age and diabetic patients duration and hospitalization expenses.Through using propensity score match comparing the difference of the patients hospitalization expenses with diabetic foot and cerebral infarction with diabetic,and matching one to one,and the calliper definition was point three to zero to finding the best matching.Results: 336 cases patients were used for analysis,and the best matching of calliper definition was point two,and then 238 cases were for analysis finally.The median hospitalization expenses of diabetic foot and cerebral infarction with diabetic patients were 19333.2 and 20042.9 yuan after matching successful,but there was no significant difference(P=0.936).Conclusion: It can be more intuitive response the higher of hospitalization expenses through comparing the difference of the patients with diabetic foot and cerebral infarction with diabetic.There was should cause attention of diabetic foot education to reduce the economic burden.