摘要
目的:通过对按病种出院患者次均费用结构和变动趋势的分析,为优化病种费用结构、控制次均住院费用不合理增长提供政策建议和决策参考。方法:以样本医院心血管病医院冠状动脉粥样硬化性心脏病2015—2017年4913例出院手术患者为例,采用结构变动度、结构变动值和结构变动贡献率等进行分析。结果:冠状动脉粥样硬化性心脏病手术患者次均住院费用结构变动度为24.10%。材料费、药品费累计贡献率为69.95%,检查费、治疗费逐年增高。结论:病种次均费用控制和费用结构优化是有效控制医药费用不合理增长的重要方面,其中材料费和药品费是次均费用控制的关键环节。开展总额预付、按病种和DRGs等综合付费方式改革是有效控制次均费用不合理增长的关键。
Objective:To analyze the structure and changes of the hospitalization cost in patients discharged from hospitals,so as to provide policy advices and decision references for optimizing the cost structure and controlling the unreasonable increase of secondary hospitalization costs.Methods:Taking coronary heart disease patients in a cardiovascular hospital as an example,the hospital HIS system collects 4913 patients discharged from the hospital from 2015 to 2017 using structural changes and contribution rates.Results:The change of the cost structure of primary hospitalization is 24.10%.The cumulative contribution rate of materials and drugs is 69.95%.The inspection fees and treatment fees are increasing year by year.Conclusion:The control of the disease sub-average cost and the optimization of the cost structure are important to effectively control the irrational increase of the medical costs.The material cost and drug cost are the key links in the control of the sub-average cost.The key to effectively control the irrational growth of sub-average costs is to carry out the reform of comprehensive payment methods such as total prepayment,disease type and DRGs.
作者
李玉萍
宋丽红
张禄生
刘雯雯
李丹丹
LI Yu-ping;SONG Li-hong;ZHANG Lu-sheng(Zhengzhou University Cancer Hospital,Henan Cancer Hospital,Zhengzhou,450003,China;不详)
出处
《中国卫生经济》
北大核心
2020年第7期65-67,共3页
Chinese Health Economics
基金
河南省软科学研究项目(142400410169)。
关键词
冠状动脉粥样硬化性心脏病
手术患者
次均住院费用
结构变动度
coronary atherosclerotic heart disease
surgery patient
sub-average hospitalization
structural variability
