대학병원에 입원한 급성 뇌졸중 환자의 진료비 결정요인:
뇌내출혈과 뇌경색의 비교 |
장혜정, 윤성상a 권영대b |
경희대학교 경영대학 의료경영학전공, 경희대학교 의과대학 부속병원 신경과학교실a, 가톨릭대학교 의과대학 인문사회의학과b |
Determinants of Inpatient Charges of Acute Stroke Patients in Two Academic Hospitals: Comparison of Intracerebral Hemorrhage and Cerebral Infarction |
Hyejung Chang |
Department of Health Services Administration, College of Business Administration and Department of Neurologya,
College of Medicine, Kyung Hee University, Seoul, Korea
Department of Medical Humanities and Social Sciencesb, College of Medicine, the Catholic University of Korea,
Seoul, Korea |
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Abstract |
Background: Intracerebral hemorrhage (ICH) and cerebral infarction, which are two types of stroke, have different
properties in terms of patient characteristics and hospital resource utilization. The two stroke types were evaluated in the
present study with respect to the associated estimated inpatient charges, and their significant determinants.
Methods: The data of 497 stroke inpatients were collected from two academic hospitals in the year 2000~2001. The
patients’ demographic and clinical information were investigated retrospectively through medical records, and their
payment data were extracted through the hospitals’ information systems. The two types of stroke patient (i.e., ICH and
cerebral infarction) were compared in terms of their demographic and clinical characteristics, and healthcare utilization.
Multiple regression models were developed to examine the influence of demographic and clinical factors on inpatient
charges.
Results: The mean length of hospital stay was 22.4 days for ICH patients and 18.3 days for those with cerebral infarction;
the total inpatient charges were 5,777 and 3,908 thousand Korean won, respectively. While stroke severity, intensive care
unit admission, surgery, and death were significant factors on inpatient charges for ICH patients (R2=0.426), additional
factors such as diabetes, hospital, and department of care were significant for cerebral infarction patients (R2=0.342).
Conclusions: The inpatient charges and their determinants differed between ICH and cerebral infarction. However, the
length of hospital stay was found to be the most significant determinant of inpatient charges for both stroke types; stroke
severity was also important with regard to the estimation of inpatient charges. Key Words: Cerebral hemorrhage, Cerebral infarction, Health resources, Hospital charges, Length of stay |
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