摘要
目的探究慢性阻塞性肺疾病患者住院费用构成、变动趋势及影响因素,为优化住院费用结构提供参考。方法收集2019年1月1日-2023年12月31日湖北省黄冈市某综合医院3053例慢性阻塞性肺疾病患者住院费用资料,运用灰色关联法、结构变动度法衡量住院各项费用与住院总费用间的关联程度和结构变动情况;多因素Logistic回归分析住院费用的影响因素。结果慢性阻塞性肺疾病患者的年次均住院费用逐年下降。在次均住院费用的构成中,药品费占据主导地位,平均占比高达37.86%,随后是诊断费占21.53%和治疗费占17.52%。在关联性方面,医疗服务费(0.925)、药品费(0.880)和诊断费(0.840)呈现较高的相关性。多因素Logistic回归分析显示住院天数、使用抗菌药物、是否有出院31天内再住院计划是住院费用的影响因素。其中住院天数对住院费用的影响最为显著,住院天数的增多带来住院费用的不断攀升。结论慢性阻塞性肺患者的经济压力有所减轻,药品费控制措施成效明显,控费的关键在于检查费,住院天数、使用抗菌药物、是否有出院31天内再住院计划皆影响住院费用,需适度提升技术性劳务项目的费用比例,继续推行医保支付改革,以进一步改善住院费用结构。
Objectives To explore the composition,changing trend and influencing factors of hospitalization costs of COPD patients,and provide reference for optimizing the cost structure of COPD patients.Methods Data on the inpatients'hospitalization costs composition of 3053 COPD patients in a general hospital in Huanggang City of Hubei Province from January 1st,2019 to December 31st,2023 were collected.The correlation degree and structural variations between individual hospitalization costs and total hospitalization costs were measured by grey correlation method and structural change method.Multivariate Logistic regression analysis was conducted to assess the influencing factors of hospitalization expenses.Results The average hospitalization cost for COPD patients had demonstrated a consistent decline yearly.In the composition of the average hospitalization costs,the drug cost dominated,accounting for 37.86%on average,followed by the diagnosis cost(21.53%)and treatment cost(17.52%).In terms of correlation,the medical service fee(0.925),drug cost(0.880)and diagnosis cost(0.840)showed a high correlation.Multivariate logistic regression analysis showed that the length of hospitalization stay,the use of antimicrobial drugs,and whether there was a plan for rehospitalization within 31 days of discharge were influencing factors of hospitalization costs.Among them,the duration of hospitalization had the most pronounced effect on medical expenses,with an increase in the number of days spent in the hospital leading to a steady surge in overall costs.Conclusions The financial pressure of COPD patients was alleviated,and the drug cost control measures were effective.The key to cost control lay in the examination fee,the number of days in hospital,the use of antibiotics,and whether there was a re-hospitalization plan within 31 days of discharge would affect the hospitalization cost.It was necessary to moderately increase the cost proportion of technical labor projects and continue to implement the DIP payment reform to further improve the hospitalization cost structure.
作者
姜梦琦
刘晓娜
吴琦
桂晓苗
Jiang Mengqi;Liu Xiaona;Wu Qi;Gui Xiaomiao(School of Public Health and Wellness,Hubei University of Medicine,Shiyan 442000,Hubei Province,China;不详)
出处
《中国病案》
2024年第12期74-78,共5页
Chinese Medical Record
基金
湖北省卫生管理与卫生事业发展研究中心2023年开放基金项目(2023YB006)。
