广西某医院剖宫产病例住院费用影响因素研究

Study on the influencing factors of hospitalization cost of cesarean section cases in a hospital in Guangxi, China

目的研究广西某三甲医院剖宫产病例住院费用的影响因素及其影响的效应,为卫生行政部门完善医疗保险制度,控制医疗费用的过快增长提供参考意见和建议。方法提取了2016至2020年29216例剖宫产病例的病案首页数据,进行单因素分析、多因素分析、通径分析。结果主要影响因素为严重并发症与合并症、转科、输血、抢救、其他手术、高龄产妇,影响因素的总效应输血0.258、抢救0.211、转科0.145、严重并发症与合并症0.130、其他手术0.087、高龄产妇0.017。结论高龄产妇直接作用于全体剖宫产病例的住院总费用,严重并发症与合并症、转科、输血、抢救、其他手术五个影响因素既直接作用于全体剖宫产病例的住院总费还通过住院天数间接作用于全体剖宫产病例的住院总费用。提高诊疗水平、降低产科的并发症与合并症、优化医疗质量管理、减短无效住院天数、加强健康宣教等一系列综合措施,有效降低剖宫产住院费用的快速增长。

Objective To study the influencing factors of hospitalization cost of cesarean section cases and its influencing effect in a tri methyl hospital in Guangxi,so as to provide reference opinions and suggestions for health administrative department to improve the medical insurance system and control the too rapid growth of medical costs.Methods Information from the medical record homepage of 29216 cesarean section cases from 2016 to 2020 was extracted for univariate analysis,multivariate analysis and path analysis.Results The main influencing factors were severe complication with comorbidity,transfer,blood transfusion,rescue,other surgery,advanced maternal age,the total effect of influencing factors were 0.258 for blood transfusion,0.211 for rescue,0.145 for transfer,0.130 for severe complication with comorbidity,0.087 for other surgery,and 0.017 for advanced maternal age.Conclusion Advanced maternal age was directly related to the total hospitalization cost of the whole cesarean section cases,and the five influencing factors,such as severe complications and comorbidities,transfer,blood transfusion,rescue,and other procedures,were both directly related to the total hospitalization cost of the whole cesarean section cases and indirectly related to the number of hospitalization days,increasing the diagnosis and treatment level,decreasing the complications and comorbidities of the whole cesarean section casesA series of comprehensive measures,such as optimizing medical quality management,reducing the number of invalid hospital days,and strengthening health catharsis,are effective in reducing the rapidly increasing cost of hospitalization for cesarean section.