| Summary: | 碩士 === 高雄醫學大學 === 醫務管理學研究所碩士在職專班 === 96 === This study aims to explore the hospital stay and medical costs of head-injured patients, to compare the differences based on the demographic characteristics and disease features as well as to analyze the demographic and disease factors which affect hospital stay and medical expense. Retrospective Secondary Data Analysis is conducted to do this study. Hospitalized head-injured patients data were obtained from a medical center in southern Taiwan from 2004 to 2006. The medical records of 1,527 patients were analyzed. The Glasgow Coma Scale Score of patients were collected through sureying the records of patients by three neurosurgical nursing practitioners. The data of medical expense were obtained from the claimed reimbursement data of the medical center to the Bureau of National Health Insurance.
The rate of male head-injured patients was 56.3% that is more than the rate of female head-injured patients. Most of head-injuried patient (26.3%)are aged betwem 19to34, followed by those aged 65+ years old (23.1%). The most prevalent injuries were mild head injuries (74.7%). most complicated cases were accompanied with 4 sub-diagnoses (29.5%), followed by 2 sub-diagnoses (23.8). The patients with cranial surgery made up 18% of all the head-injured patients, with 52.6% of ICU care .The averaged hospital stay was 10.5 days and the averaged medical costs amounted to NTD73,425, less than the average duration and costs of other medical centers in Taiwan (13.07 days, NTD95,436). Among the medical costs, pharmacy, surgical anesthesia, and treatment (NTD9,801, 10,474, 13,648) were also less than the average costs of medical centers in Taiwan (NTD16,198, 16,086, 18,427). The other cost were approximated to the average costs of other medical centers in Taiwan. It inferred that the costs of pharmacy, surgical anesthesia and treatment are important determinator of the total medical costs.
The main factors affecting hospital stay were sex, age, finally discharged situation, injury types, injury complication, cranial surgery, and ICU care. While the main factors affecting total medical costs included health situation when a patient discharged, injury types, injury complication, cranial surgery, and ICU care. The hospital managers should focus on these issues and find out way to reduce the medical expense.
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