中国全科医学2025，Vol.28Issue(17)：2127-2133,7.DOI:10.12114/j.issn.1007-9572.2024.0409
慢性阻塞性肺疾病患者共病模式系统聚类分析及其对住院费用的影响
Systematic Cluster Analysis of Comorbidity Patterns in Patients with Chronic Obstructive Pulmonary Disease and the Impact on Hospitalization Costs
摘要
Abstract
Background Chronic obstructive pulmonary disease(COPD)patients often present with multiple comorbidities,which increase the complexity of treatment and the healthcare of burden.While comorbidities significantly impact the management of COPD patients,existing research primarily focuses on individual comorbidities,lacking systematic analysis of multiple comorbidity patterns and hospitalization costs.Objective To investigate the comorbidity characteristics and patterns in patients with COPD,analyzing how different features and comorbidity patterns affect hospitalization costs.The findings will provide a basis for personalized health management and resource allocation for COPD patients.Methods A retrospective analysis was conducted on 5 061 inpatients diagnosed with COPD at the First Affiliated Hospital,Guangzhou Medical University from 2020 to 2023.Systematic clustering analysis was employed to construct dendrograms,identifying comorbidity patterns among COPD patients.Multiple group comparisons were performed to assess the basic characteristics of these patterns,then multiple linear regression analysis was utilized to evaluate the impact of each comorbidity pattern on total hospitalization costs,western medicine costs,and antibacterial medication costs.Results There are a total of 4 343 patients with COPD,and the comorbidity was 85.81%.Systematic clustering analysis identified six comorbidity patterns among COPD patients:cardiovascular and metabolic diseases,hepatorenal diseases,digestive system diseases,arthropathy diseases,cancer and respiratory system diseases.There were significant differences in sex,age,BMI and smoking history among patients with 6 comorbidity models(P<0.05).Multiple linear regression analysis revealed that BMI,cancer pattern,and respiratory system diseases pattern all had impacts on total hospitalization costs,western medicine costs and antibacterial medication costs(P<0.05),with the respiratory system diseases pattern having the most substantial impact on total hospitalization costs(β=0.125,P<0.001).Conclusion Comorbidity patterns in COPD can be categorized into six clusters.BMI,cancer pattern and respiratory system diseases pattern are the primary factors influencing hospitalization costs.关键词
慢性阻塞性肺疾病/共病模式/健康管理/住院费用/聚类分析Key words
COPD/Comorbidity patterns/Health management/Hospitalization costs/Systematic clustering分类
临床医学引用本文复制引用
程卓卓,张睿,徐浩枫,黄君庭,梁子敬,晏平..慢性阻塞性肺疾病患者共病模式系统聚类分析及其对住院费用的影响[J].中国全科医学,2025,28(17):2127-2133,7.基金项目
广东省科学技术研究基金项目(C2022101) （C2022101）
广州市科技局市校(院)联合资助(登峰医院)项目(202201020454) （院）
