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本文对马塞诸塞州五所医院1987年16908名住院病人进行了连续访问,获得了三项直接衡量社会经济水平(收入、职业、教育)的有关资料。经调查发现,社会经济水平最低的病人比较高水平的住院天数长3～30%,其差别随医院和社会经济水平指征而变化(11/15的比较组P≤0.05)。社会经济水平最低的病人比较高水平病人的住院费用高1～18%(9/15的比较组P≤0.05)。当调整了年龄、疾病严重程度和DRG后,在14/15比较组中社会经济水平最低病人的住院天数均长于较高水平的病人(其中7/15比较组P<0.05),并且13/15比较组的医疗费用也高于社会经济水平较高的病人。二者住院天数的差别范围为21%;费用的差别范围为13%。本次调查结果表明,较低社会经济水平的住院病人其住院天数较长,并且可能消耗更多的资源。因此,为医院增补治疗贫穷病人的费用值得进一步考虑。
In this article, a continuous visit was made to 1,908 inpatients in five hospitals in Massachusetts during 1987, and three related data were directly measured to measure social and economic levels (income, occupation, education). The survey found that patients with the lowest socio-economic level had a high level of hospitalization days of 3 to 30%, and the differences varied with the indications of the hospital and socio-economic level (11/15 comparison group P ≤ 0.05). Patients with the lowest socioeconomic level have a higher hospitalization cost of 1 to 18% compared with patients with high levels (P<0.05 for a 9/15 comparison group). When adjusted for age, severity of illness, and DRG, the number of days of hospitalization in the lowest socioeconomic class of patients in the 14/15 comparison group was longer than the higher number of patients (of which 7/15 comparison groups were P<0.05), and 13/15 The medical expenses of the comparative group are also higher than those with higher socioeconomic level. The difference in the length of stay between the two hospitals was 21%; the difference in the cost range was 13%. The survey results show that hospitalized patients with lower socioeconomic levels have longer hospital stays and may consume more resources. Therefore, the cost of supplementing hospitals with poor patients deserves further consideration.