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山西省医院骨科手术患者药品费用的特征与影响因素研究
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| 篇名： | 山西省医院骨科手术患者药品费用的特征与影响因素研究 |
| TITLE： | The characteristics and influencing factors of medicine cost for orthopedic surgery patients in hospitals of Shanxi province |
| 摘要： | 目的 分析山西省骨科手术患者药品费用的特征和影响因素，为合理管控骨科手术患者的药品费用提供参考。方法回顾性收集山西省2016－2021年584204例骨科手术患者的病例信息。按照不同年份、地区、医院级别、手术类型和手术切口类型进行分类，对药品费用进行分析。采用单因素分析和广义线性回归模型对药品总费用的影响因素进行分析，并采用结构方程模型进行验证。结果关节置换术（占42.61%）和骨折后外固定术（占12.60%）是最常见的手术类型。不同手术类型药品总费用在不同地区和不同等级医疗机构之间的差异均有统计学意义（P＜0.05），晋中地区的骨折后外固定术药品总费用最高（[11719.97±4374.73）元]，三级甲等医院的骨折后外固定术药品总费用最高（[13584.71±4531.82）元]。Ⅰ类切口手术中骨折后外固定术的抗菌药物费用最高（[1176.25±341.42）元]。广义线性回归模型显示，医院所属地、医院级别、性别、付款方式、住院天数和手术类型是药品总费用的独立影响因素（P＜0.05）。结构方程模型进一步揭示，医院级别、付款方式和手术类型对药品总费用有显著影响（P＜0.05）。结论需关注Ⅰ类切口手术抗菌药物费用高的情况，进一步研究其合理使用方案。 |
| ABSTRACT： | OBJECTIVE To analyze the characteristics and influencing factors of medicine cost for orthopedic surgery patients in Shanxi province， and to provide reference for the rational management of medicine cost in orthopedic surgery patients. METHODS A retrospective analysis was conducted on the case information of 584 204 orthopedic surgery patients in Shanxi province from 2016 to 2021. Medicine cost was analyzed by year， region， hospital level， type of surgery and type of surgical incision. Single factor analysis and generalized linear regression model were used to analyze the influencing factors of total medicine cost， and structural equation model was used for verification. RESULTS The research findings indicated that joint replacement surgery （42.61%） and post-fracture external fixation surgery （12.60%） were the most common types of procedures. There was statistical significance in medicine cost for different surgical types among different regions and hospital levels （P＜0.05）. In the Jinzhong region， the total medicine cost for post-fracture external fixation surgery was the highest （[ 11 719.97±4 374.73） yuan]， while in tertiary grade A hospitals， the total medicine cost for post-fracture external fixation surgery was also the highest （[ 13 584.71±4 531.82） yuan]. Among class Ⅰ incision surgeries， the cost of antibiotics for post-fracture external fixation surgery was the highest （[ 1 176.25±341.42） yuan]. Generalized linear regression model revealed that hospital location， hospital level， gender， payment method， length of hospital stays， and surgical type were the independent influencing factors for total medicine cost （P＜0.05）. Structural equation model further disclosed that hospital level， payment type， and surgical type had significant effects on total medicine cost （P＜0.05）. CONCLUSIONS Attention should be paid to the high cost of antibiotics for class Ⅰ incision surgery， and further research on their rational use should be conducted. |
| 期刊： | 2024年第35卷第05期 |
| 作者： | 李维鹏；尚楠；张智琪；李赟；郑晓俊 |
| AUTHORS： | LI Weipeng，SHANG Nan，ZHANG Zhiqi，LI Yun，ZHENG Xiaojun |
| 关键字： | 山西省；骨科手术；药品费用；影响因素 |
| KEYWORDS： | Shanxi province； orthopedic surgery； medicine |
| 阅读数： | 30 次 |
| 本月下载数： | 1 次 |
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