中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2013年
3期
319-321
,共3页
临终病人%院内诊疗%队列研究
臨終病人%院內診療%隊列研究
림종병인%원내진료%대렬연구
Terminally ill%Institutional practice%Cohort studies
目的 通过研究老年临终患者医疗特征,为老年人临终生命质量提高及临终医疗费用优化配置提供数据支持. 方法 采用历史性队列研究,以60岁及以上年龄因素为暴露因子,随机抽取暴露组228人,对照组156人为研究对象,观察其入院疾病、诊疗过程和住院费用特征. 结果 老年组和非老年组入院疾病构成差异有统计学意义(x2 =91.345,P＜0.0001),其中恶性肿瘤构成比较差异无统计学意义(x2 =9.761,P=0.082)；老年组手术构成(7.0％)低于非老年组(17.9％),老年组住院12.5 d和抢救3次均高于非老年组,大型医疗设备使用构成比差异无统计学意义(x2=0.029,P=0.864);老年组住院总费用15356.0元、药费6448.3元、西药费5070.0元、中药费895.0元和药品比重40.2％均高于非老年组. 结论 老年临终患者多为已丧失手术指征的慢性病患者,需要长期药物维持生命,医疗费用消耗较大.
目的 通過研究老年臨終患者醫療特徵,為老年人臨終生命質量提高及臨終醫療費用優化配置提供數據支持. 方法 採用歷史性隊列研究,以60歲及以上年齡因素為暴露因子,隨機抽取暴露組228人,對照組156人為研究對象,觀察其入院疾病、診療過程和住院費用特徵. 結果 老年組和非老年組入院疾病構成差異有統計學意義(x2 =91.345,P＜0.0001),其中噁性腫瘤構成比較差異無統計學意義(x2 =9.761,P=0.082)；老年組手術構成(7.0％)低于非老年組(17.9％),老年組住院12.5 d和搶救3次均高于非老年組,大型醫療設備使用構成比差異無統計學意義(x2=0.029,P=0.864);老年組住院總費用15356.0元、藥費6448.3元、西藥費5070.0元、中藥費895.0元和藥品比重40.2％均高于非老年組. 結論 老年臨終患者多為已喪失手術指徵的慢性病患者,需要長期藥物維持生命,醫療費用消耗較大.
목적 통과연구노년림종환자의료특정,위노년인림종생명질량제고급림종의료비용우화배치제공수거지지. 방법 채용역사성대렬연구,이60세급이상년령인소위폭로인자,수궤추취폭로조228인,대조조156인위연구대상,관찰기입원질병、진료과정화주원비용특정. 결과 노년조화비노년조입원질병구성차이유통계학의의(x2 =91.345,P＜0.0001),기중악성종류구성비교차이무통계학의의(x2 =9.761,P=0.082)；노년조수술구성(7.0％)저우비노년조(17.9％),노년조주원12.5 d화창구3차균고우비노년조,대형의료설비사용구성비차이무통계학의의(x2=0.029,P=0.864);노년조주원총비용15356.0원、약비6448.3원、서약비5070.0원、중약비895.0원화약품비중40.2％균고우비노년조. 결론 노년림종환자다위이상실수술지정적만성병환자,수요장기약물유지생명,의료비용소모교대.
Objective To explore the medical characteristics of end of-life care in elderly inpatients for improving their quality life and distributing appropriately the end-of-life medical expenditure.Methods The historical cohort study was used to survey the characteristics of admission disease,diagnosis and treatment and hospitalization expenditure.The patients were divided into the elderly group (age 60 years and over,228 cases) and control group (age ＜60 years,156 cases).Results There was a statistically significant difference in the admission disease proportion between elderly group and control group (x2 =91.345,P ＜ 0.0001),but the malignant tumor proportion had no differences between the two groups (x2 =9.761,P=0.082); the operation proportion in elderly group (16 cases,7.0％) was lower than in control group (28 cases,17.9％) ; the hospital stay time was longer in elderly group (12.5 days) than in control group (5 days),and the salvage times of elderly group (3 times)was more than that of control group,but the usage of medical device had no differences between the two groups (x2 =0.029,P =0.864).The hospitalization expenditure,medicine expenditure,western medicine expenditure,traditional Chinese medicine expenditure,and medicine proportion were higher in elderly group (15356.0 yuan,6448.3 yuan,5070.0 yuan,895.5 yuan,40.2％,respectively) than in control group.Conclusions Most of the elderly patients with chronic diseases at the end of life have no indication of operation and rely on medicine to maintain life for a long time,and the end-of-life medical expenditure is higher.
