摘要
目的分析门诊糖尿病足患者基本情况和治疗费用,分析治疗费用的影响因素。方法选择2020年10月至2022年6月就诊于四川大学华西医院门诊伤口治疗中心的糖尿病足患者,回顾性分析患者一般资料和创面资料,包括性别、年龄、糖尿病病史、患足、糖尿病足Wagner分级、溃疡病程、溃疡部位、大小、治疗费用、治疗次数、患者去向等,分析门诊糖尿病足患者治疗费用的影响因素。数据比较采用χ^(2)检验、非参数检验、多元线性逐步回归。结果共纳入194例糖尿病足患者671例次治疗记录,其中男性患者占69.75%,女性患者占30.25%,男性多于女性;60岁以下中青年患者占33.68%,60~74岁患者占30.70%,75岁及以上患者占35.62%;糖尿病病史10年及以上患者为主,占68.26%,病史10年以下者占31.74%;以单足患病为主,左、右足分别占44.71%和52.01%,双足同时患病者占3.28%;糖尿病足Wagner分级以3级及以上患者居多,其中3级患者占46.80%、4~5级患者占47.84%,1~2级患者占5.37%;糖尿病足溃疡病程以1个月以上慢性溃疡为主,占79.28%,1个月以内患者占20.72%;溃疡部位多位于足趾(41.58%)和足底/足背/足跟(40.39%);患者去向以住院(37.56%)和下转医疗机构/回家(42.32%)为主。患者单次治疗费用中位数为83.42(65.49,103.82)元,单次费用最高者为385元;累计治疗费用中位数为112.34(73.02,221.52)元,累计费用最高者为4919.57元。单因素分析结果显示,糖尿病足患者治疗费用与年龄(χ^(2)=17.515,P=0.000)、患足(χ^(2)=15.633,P=0.000)和患者去向(χ^(2)=8.054,P=0.045)有关。多元逐步回归分析结果显示,影响门诊糖尿病足患者治疗费用的因素为年龄(t=-2.735,P=0.006)。结论门诊糖尿病足患者治疗费用的影响因素为年龄,中青年患者治疗费用较高。门诊治疗费用是糖尿病足疾病负担的重要组成部分,应提高对糖尿病足患者的科学分级管理能力。
Objective To analyze the basic condition and treatment cost of outpatient diabetic foot patients,and analyze the influencing factors of treatment cost.Methods Patients with diabetic foot admitted to the Wound Care Center of West China Hospital of Sichuan University from October 2020 to June 2022 were selected for retrospective analysis of the general and wound data of the patients,including gender,age,history of diabetes,affected foot,Wagner grades,duration of ulcers,site of ulcers,size,treatment cost,treat frequency,patient's dispositon,etc,analyzed the influencing factors of treatment cost in outpatients with diabetic foot.Data were compared by Chi-square test,nonparametric test and multiple linear stepwise regression.Results A total of 194 patients with diabetic foot and 671 treatment records were included,among which male patients accounted for 69.75%and female patients accounted for 30.25%,more males than females.Young and middle-aged patients under 60 years old accounted for 33.68%,patients between 60 and 74 years old accounted for 30.70%,and patients aged 75 and above accounted for 35.62%.The majority of patients with diabetes history of 10 years or more were 68.26%,and those with diabetes history of less than 10 years were 31.74%.The majority of patients were on one foot,with left foot and right foot accounting for 44.71%and 52.01%,respectively,and both feet accounted for 3.28%.The Wagner grades of diabetic foot was mainly grade 3 and above,among which 46.80%were grade 3 patients,47.84%were grade 4 to 5 patients and 5.37%were grade 1 to 2 patients.The duration of diabetic foot ulcer was chronic ulcer over 1 month,accounting for 79.28%,and patients within 1 month accounted for 20.72%.The ulcers were mainly located on the toe(41.58%)and the sole/dorsal/heel(40.39%).Most of the patients were hospitalized(37.56%)and transferred to medical institutions/home(42.32%).The median single treatment cost of patients was 83.42(65.49,103.82)yuan,and the highest single treatment cost was 385 yuan.The median cumulative cost of treatment was 112.34(73.02,221.52)yuan,and the highest cumulative treatment cost was 4919.57 yuan.Univariate analysis showed that treatment cost of diabetic foot patients was related to age(χ^(2)=17.515,P=0.000),foot(χ^(2)=15.633,P=0.000)and patient's dispositon(χ^(2)=8.054,P=0.045).Multiple stepwise regression analysis showed that the factor affecting the cost of treatment for outpatient diabetic foot patients was age(t=-2.735,P=0.006).Conclusion The influencing factor of treatment cost for outpatient diabetic foot patients was age,and the cost was higher in middle-aged and young patients.The cost of treatment in outpatient clinic is an important part of the burden of diabetic foot disease.The ability of scientific grading management of diabetic foot patients should be improved.
作者
余静雅
戴燕
石玉兰
向利娟
吴淑君
Yu Jingya;Dai Yan;Shi Yulan;Xiang Lijuan;Wu Shujun(West China School of Nursing,Wound Care Center,West China Hospital of Sichuan University,Chengdu 610041,China)
出处
《中华损伤与修复杂志（电子版）》
CAS
2023年第2期128-133,共6页
Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)
基金
四川大学华西护理学科发展专项基金(HXHL19006)。
关键词
门诊
糖尿病
糖尿病足
治疗费用
换药
Outpatient
Diabetes mellitus
Diabetes foot
Treatment cost
Dressing change
作者简介
余静雅,女,硕士,四川大学华西医院门诊部伤口治疗中心护师,主要从事伤口治疗及科研工作。以第一作者/通讯作者发表学术论文6篇,主研厅局级、院级课题3项。以第一发明人获得实用新型专利1项;通信作者:戴燕,Email:1846703501@qq.com。
