医疗保险患者三个病种住院费用的影响因素分析

Factors influencing health insurance patients hospitalization expenses for three disease entities

目的了解影响医疗保险患者住院费用的主要因素,为控制医疗费用的不合理增长和医疗保险支付方式的改革提供参考依据。方法收集某市两所医院3年中3个病种的所有医疗保险病例,共647例,对于可能的影响因素采用多元逐步回归法进行统计分析。结果不同医院、住院天数、是否手术、药费比例及全省医疗服务价格调整等,是医疗保险患者住院费用的影响因素;缩短住院天数、降低药费比例是控制费用的关键。结论应制定科学的单病种诊疗常规和费用标准,加快和深化医疗保险制度改革,在试行某些单病种付费的基础上,实行按病种付费。

Objective To identify the chief factors influencing health insurance patients＇ hospitalization expenses so as to provide basis for the control of irrational increase in medical expenses and reform in the mode of medical insurance payment. Methods All the medical insurance cases involving the three disease entities in two hospitals of a certain city for the past three years, which totaled 647, were collected and a statistical analysis was made of the possible influencing factors using multi-stepwise regression analysis. Results The factors influencing the health insurance patients＇ hospitalization expenses included choice of hospitals, length of stay, performance of operations, proportion of drug fees, and provincewide readjustment of medical service prices. Reducing length of stay and lowering proportion of drug fees were the key to controlling expenses. Conclusion It is imperative to formulate scientific diagnostic and treatment routines and expense standards for single disease entities, speed up and deepen reform in the medical insurance system, and, on the basis of trying out payment based on certain single disease entities, implement payment based on disease entities.