Clinical features of geriatric patients with neurodegenerative diseases and influencing factors for their medical expenses
10.3760/cma.j.cn115354-20200505-00332
- VernacularTitle:老年NDDs住院患者的特点及其医疗费用的影响因素分析
- Author:
Guihua LI
1
;
Jiewen QIU
;
Penghai YE
;
Zhiling ZHANG
;
Guoyou PENG
;
Miaomiao ZHOU
;
Lin LU
;
Hanqun LIU
;
Wenyuan GUO
;
Xintong LIU
;
Pingyi XU
Author Information
1. 广东省第二人民医院神经内科，广州 510317（现为广州医科大学附属第一医院神经内科博士后 510120）
- Keywords:
Neurodegenerative disease;
Geriatric;
Hospitalization characteristic;
Medical expenses
- From:
Chinese Journal of Neuromedicine
2020;19(11):1134-1141
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the characteristics of senile neurodegenerative diseases (NDDs) inpatients in south China, especially in Guangdong province, and explore the influencing factors for their medical expenses.Methods:The medical records of 7231 patients with NDDs≥65 years were collected in the electronic health database of our hospital from January 2010 to December 2019, including gender, age, admission ways, chief complaints, length of hospital stays and medical expenses. On the basis of median of the medical expenses (21 345 yuan) of these patients, they were divided into low cost (<21 345 yuan) group and high cost (≥21 345 yuan) group. Univariate Logistic analysis and multivariate Logistic regression analysis were conducted to screen the influencing factors for medical expenses and the independent influencing factors.Results:(1) The main age group of geriatric inpatients with NDDs were 70-79 years (40.96%); the admission source was mainly outpatient (56.70%), and length of hospital stays of a large percent of patients (44.50%) were 8-14 d. (2) From 2010 to 2019, the number of hospitalized geriatric patients with NDDs showed an increasing trend year by year, the overall trend of length of hospital stays was shortened, and the medical expenses showed gradual increase; the causes of hospitalization, percentages of patients caused by infection, abnormal blood pressure and water-electrolyte metabolism disturbances showed decreased trend, percentages of patients caused by heart diseases, cerebrovascular accidents and mental-psychological diseases showed increased trend, and the proportions of patients caused by fracture/trauma/wound injuries were generally stable. The proportion of patients returning home and mortality rate after hospital discharge were declined, and the proportion of patients returning to other medical or community institutions was increased. (3) Living in ICU, length of hospital stays, diabetes, nosocomial infection, chronic kidney disease, urinary tract infection, tumble, body mass index, and anticholinergic drugs were independent risk factors influencing the medical expenses ( P<0.05). Conclusions:An aging trend is noted in patients with NDDs; the number of hospitalized patients and medical expenses increase year by year, and the length of hospital stays gradually decreases. In view of the many factors that influence the medical expenses of this disease, it is suggested to develop the corresponding standardized treatment plan for the main influencing factors in clinical practice.
