대학병원에 입원한 급성 뇌졸중 환자의 진료비 결정요인: 뇌내출혈과 뇌경색의 비교
Determinants of Inpatient Charges of Acute Stroke Patients in Two Academic Hospitals: Comparison of Intracerebral Hemorrhage and Cerebral Infarction
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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.
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