2型糖尿病患者血糖控制与医保、住院费用的关系分析

Analysis of the Relationship between Blood Glucose Control and Medical Insurance and Hospitalization Expenses in Patients with Type 2 Diabetes Mellitus

摘要: 目的：研究2型糖尿病患者在不同的医疗保险制度下血糖控制及并发症情况、住院费用、住院天数的相关性。方法：取自2017年1月~2020年10月住院的2型糖尿病患者1057例。收集患者年龄、性别、医保类型、空腹血糖、餐后2小时血糖、糖基化血红蛋白、并发症情况，住院费用，住院天数。用SPSS23统计软件对数据进行统计分析。结果：1) 调查2017年1月~2020年10月住院的2型糖尿病患者1057例，医保患者占97%。2) 空腹血糖与医保类型无明显关系，P > 0.05，相关系数R值 = 0.047，显著性0.301。空腹血糖与患者年龄、住院天数及是否因急性心梗住院有关系，P值 < 0.05。空腹血糖与医保费用无明显关系，P值 = 0.176，R值 = 0.061。3) 餐后2小时血糖与医保类型关系不明显，相关系数R值 = 0.056，显著性为0.282。在心内科住院的糖尿病患者餐后血糖控制差的较多。4) 控制餐后2小时血糖后，住院天数与患者年龄、急性心梗、空腹血糖、糖化血红蛋白以及住院的总费用和医保费用有关系，P值 < 0.05。与医保类型无明显关系。控制医保类型后，患者住院天数与餐后血糖、糖化血红蛋白、空腹血糖、急性心梗、住院费用有关系，P < 0.05。5) 血糖控制较好的患者住院医保费用较少。相关系数R值 = 0.005，显著性为0.918。医保费用与急性心梗及介入治疗有关系。P < 0.05。住院费用与糖尿病患者是否合并急性心梗有关系P值 < 0.01，相关系数R = 0.507，显著相关。结论：1) 住院的2型糖尿病患者中，医保患者占97%。2) 患者的空腹血糖控制情况与医保类型、住院医保费用无明显关系，与患者年龄，住院天数及是否因急性心梗住院有关系。3) 餐后2小时血糖与医保类型关系不明显，在心内科住院的糖尿病患者餐后血糖控制差的较多。4) 控制餐后血糖后，患者的住院天数与患者年龄、急性心梗、空腹血糖、餐后血糖、糖化血红蛋白以及住院费用有正相关关系。5) 住院医保费用与急性心梗及介入治疗有关系。与医保类型无明显关系。血糖控制较好的患者住院医保费用较少。

Abstract: Objective: To study the correlation between blood glucose control, complications, hospitalization expenses and length of stay in patients with type 2 diabetes under different medical insurance systems. Methods: 1057 patients with type 2 diabetes mellitus were selected from January 2017 to October 2020. Age, gender, type of medical insurance, fasting blood glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin, complications, hospitalization expenses and length of stay were collected. Spss23 software was used to analyze the data. Results: 1) 1057 patients with type 2 diabetes were investigated from January 2017 to October 2020, of which 97% were Medicare patients. 2) There was no significant relationship between FBG and the type of medical insurance, P > 0.05, r = 0.047, conspicuousness 0.301. Fasting blood glucose was associated with age, length of hospital stay and hospitalization due to acute myocardial infarction (P < 0.05). There was no significant relationship between fasting blood glucose and medical insurance cost, P = 0.176, r = 0.061. 3) The relationship between postprandial 2-hour blood glucose and the type of medical insurance is not obvious, the correlation coefficient r = 0.056, and the significance is 0.282. In the Department of Cardiology, the patients with poor postprandial blood glucose control were more. 4) After controlling 2 hours postprandial blood glucose, the length of hospital stay was related to age, acute myocardial infarction, fasting blood glucose, glycosylated hemoglobin, total hospitalization expenses and medical insurance expenses, P < 0.05. There was no significant relationship between the type of medical insurance and the type of medical insurance. After controlling the type of medical insurance, the length of hospital stay was related to postprandial blood glucose, glycosylated hemoglobin, fasting blood glucose, acute myocardial infarction and hospitalization expenses, P < 0.05. 5) Patients with better blood glucose control have less medical insurance expenses. The correlation coefficient r = 0.005, and the significance was 0.918. The cost of medical insurance is related to acute myocardial infarction and interventional therapy, P < 0.05. There was a significant correlation between hospitalization expenses and diabetic patients with acute myocardial infarction (P < 0.01, r = 0.507). Conclusion: 1) Among the hospitalized patients with type 2 diabetes, the medical insurance patients accounted for 97%. 2) The control of fasting blood glucose had no significant relationship with the type of medical insurance and hospitalization expenses, but with the age of patients, length of stay and whether they were hospitalized due to acute myocardial infarction. 3) The relationship between postprandial blood glucose control and postprandial blood glucose control was not obvious. 4) After the control of postprandial blood glucose, the length of hospital stay was positively correlated with age, acute myocardial infarction, fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin and hospitalization expenses. 5) The medical insurance cost is related to acute myocardial infarction and interventional therapy. There was no significant relationship between the type of medical insurance and the type of medical insurance. Patients with better blood glucose control have less medical insurance expenses.