脑卒中后意识障碍患者住院费用构成及影响因素分析OA

Objective To explore the composition and influencing factors of hospitalization expenses in patients with disorders of consciousness after stroke.Methods We collected the medical record information of pa-tients with disorders of consciousness after stroke from a top-tier rehabilitation hospital from 2015 to 2020,used multiple linear regression to explore the factors affecting the hospitalization costs of the patients,and analyzed the composition of hospitalization costs for patients with different characteristics.Results The median length of stay for patients with post-stroke disorders of consciousness was 337.00 days,and the median hospitalization costs were 379 400 yuan;the average daily hospitalization costs were 1 594.68 yuan.The top three hospitalization costs were rehabilitation costs(36.55％),drug costs(17.11％),and treatment costs(12.86％).Multivariate linear re-gression analysis results showed that the payment mode,patient source,round trip of ICU,and prolonged stay sig-nificantly affected the hospitalization costs(P＜0.05).Conclusions It is vital to emphasize the service needs of patients with disorders of consciousness after stroke and expand the supply of rehabilitation services,to explore a multi-faceted composite health insurance payment model suitable for severe-case rehabilitation with reasonable cost-sharing for excess expenditures,to reduce the disparities in medical resource allocation between regions to ensure patients access to equitable healthcare services,and to address the issue of"prolonged medical care"during the patients' medical journey for repairing the discontinuities in the rehabilitation medical service chain.