医疗保险住院费用调查及多因素分析

Investigation on hospitalization expenses for medical insurant inpatients and multivariate analysis of influencing factors

目的研究医疗保险住院病例医疗费用情况及影响因素,为制定合理的控制医疗费用措施提供参考依据。方法利用2001—2004年福建省省本级医保住院患者的费用资料,统计分析医保住院费用的变化趋势及构成,并用逐步多元回归分析法系统分析了影响不同病种住院医疗费用的有关因素。结果参保人员年住院率为5.51%,次均住院医疗费用为11583.27元,平均住院天数为23.6～28.7天。2004年个人现金支付医疗费用比例为25.97%。前5种主要住院病种为恶性肿瘤、高血压病、脑梗塞、冠心病和病毒性肝炎。住院天数为5种疾病住院费用共同的影响因素,手术病人的住院费用明显高于非手术病人。结论福建省本级医疗保险参保人员住院医疗费用较高,要加强住院病人医疗费用管理,控制不合理的医疗费用增长。

Objective To analyze the hospitalization expenses and the critical factors influencing medical cost for medical insurant inpatients. Methods The data of hospitalization expenses for Fujian provincial social medical insurance unit 2001- 2004 were used to explore trend and construction of medical cost for medical insurance and to analyze factors influencing the hospitalization expenses by using multiple step regression. Results The hospitalization yearly rate was 5.51% for insured persons. The average total hospitalization expenses were 11583.27 Yuan, the average of hospitalization days was 23.6 to 28.7 days for medical insurant inpatients. The proportion of self - bearing expense of medical insurant inpatients was 25.97% in 2004. The main diseases of medical insurant inpatients were malignant tumour, hypertension, brain infarction, coronary heart disease and viral hepatitis. The critical factors influencing total hospitalization expenses were the numbers of hospitalization days and operation. Conclusion The hospitalization expenses for insured persons was higher in Fuzhou. In order to control the rapid increase of medical expenses, the supervisory and management to the medical cost should be strengthened.