参保白内障患者住院费用及影响因素分析

Hospitalization cost and its relative factors among cataract patients with health care insurance

目的了解天津市参保白内障患者住院费用构成及其影响因素,为控制医疗费用的不合理增长提供参考依据。方法从天津市2003-2007年参保住院患者资料库中抽取白内障患者5 030例,对其住院费用情况进行回顾性分析。结果天津市2003-2007年参保白内障患者人均住院费用中位数为6 166.29元;其中一级医院为4 966.46元;二级医院为6 038.54元;三级医院为6 362.79元;参保白内障患者的住院费用中,材料费、手术费、检查费、药品费、治疗费、床位费和其他费用依次占44.03%,37.58%,7.89%,4.82%,2.67%,2.20%和0.81%;多元线性回归分析结果表明,材料费、手术费和药品费比重越大、住院天数越多、医院级别越高,白内障患者住院费用越高。结论材料费比重、住院天数、手术费比重、药品费比重和医院级别是天津市参保白内障患者住院费用的主要影响因素。

Objective To identify major factors influencing hospitalization expense and constitution in cataract patients with health insurance in Tianjin and to provide reference for the control of irrational increase in medical expense.Methods A total of 5030 cataract patients with medical insurance in a hospital of Tianjin from 2003 to 2007 were recruited and their hospitalization expense were analyzed with retrospective study.Results The median of hospitalization cost was 6 166.29 RMB yuan per patient in Tianjin from 2003 to 2007.The median of hospitalization cost per patient was 4 966.46 RMB yuan for the hospital of grade one,6 038.54 RMB yuan for the hospital of grade two,and 6 362.79 RMB yuan for the hospital of grade three.The constitution of hospitalization cost for cataract patients with medical insurance were material cost（44.03%）,operation cost（37.58%）,inspection fees（7.89%）,drugs charge（4.82%）,treatment charge（2.67%）,bed charge（2.20%）,and other charges（0.81%）.The results of multi-factor analysis showed that the hospitalization cost was positively correlated with the ratio of material,operation,and inspection cost,number of days of hospitalization,and the grade of the hospital the patient stayed.Conclusion Lowering the proportion of fees for material,surgery,and drug and reducing the duration of hospitalization are the key to the control of hospitalization expenses for cataract patient.