孙倩倩,施钰琳,唐华,等.脑卒中患者住院康复期间的功能水平与康复支出的相关性及影响因素分析[J].中华物理医学与康复杂志,2025,47(4):325-330
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| 脑卒中患者住院康复期间的功能水平与康复支出的相关性及影响因素分析 |
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| DOI：10.3760/cma.j.cn421666-20240924-00785 |
| 中文关键词: 脑卒中 国际功能、残疾和健康分类康复组合 康复治疗支出 |
| 英文关键词: Stroke International Classification of Functioning Disability and Health Rehabilitation Set Rehabilitation cost |
| 基金项目:国家自然科学基金（82272614）；2023年度广东省医学科研基金指令性课题项目（C2023058） |
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| 中文摘要: |
| 目的 分析脑卒中患者住院康复期间的功能水平变化与康复治疗支出的相关性及影响因素。 方法 选取住院治疗的脑卒中患者304例，使用国际功能、残疾和健康分类康复组合(ICF-RS)评估患者入院时（入院24 h内）、住院康复10 d、出院前1 d（平均住院18 d）的功能等级，并采集其人口学资料、临床资料及康复治疗支出等信息。使用广义估计方程分析患者ICF-RS功能等级随时间的变化及危险因素，并探讨其功能等级与康复治疗支出的相关性及影响因素。 结果 脑卒中患者的住院时长（住院1 d、住院10 d）、年龄≥60岁、出血型脑卒中是脑卒中患者伴发功能障碍的风险因素（P＜0.05）。住院10 d、出院前1 d，重度功能障碍患者的频数占比明显降低，中度及轻度功能障碍患者的频数占比增高（P＜0.05）。重度功能障碍、中度功能障碍、脑卒中分期（亚急性期）、非首次康复是导致脑卒中患者康复治疗支出增加的主要因素（P＜0.05）。 结论 脑卒中患者的ICF-RS功能等级与康复治疗支出之间存在相关性，ICF-RS功能等级、脑卒中分期、是否首次康复是影响脑卒中患者康复治疗支出的主要因素。 |
| 英文摘要: |
| Objective To explore the significance of any correlation between the cost of the rehabilitation provided to stroke survivors during their hospitalization and the functional levels attained, and to analyze factors influencing that correlation. Methods The International Classification of Functioning, Disability and Health Rehabilitation Set (ICF-RS) was used to evaluate the functioning of 304 stroke survivors on their days of hospital admission and discharge, as well as on their 10th day in hospital. The cost of their rehabilitation was computed, and demographic and clinical data were collected. A generalized estimation equation was used to analyze the changes in dysfunction with time and its risk factors. The relationship between functional levels and rehabilitation cost and its influencing factors were analyzed. Results Length of stay, age≥60 and hemorrhagic stroke were significant risk factors for greater dysfunction among the stroke survivors. On the 10th day in hospital and the day before discharge (the 18th day), the frequency of severe dysfunction had decreased. The significant predictors of increased cost were severe or moderate dysfunction, the stage of stroke (sub-acute stage), and non-first rehabilitation. Conclusion Functional level is a useful predictor of rehabilitation cost. It is influenced by the stage of stroke and non-first rehabilitation. |
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