医保患者人工关节置换术住院费用分析

Analysis of Hospital Charges for Patients' Joint Prosthesis Replacement Medical Insurance

目的:了解人工关节置换术住院费用情况及影响因素,为合理控制医疗费用提供依据。方法:采用回顾性调查的方法,对2006—2009年在江苏省苏州市三级医院住院的手术方式为人工髋关节置换术、人工股骨头置换术及人工膝关节置换术的525例参保人员住院费用情况进行研究,并利用多元逐步回归分析方法对各影响因素进行综合分析。结果:2006—2009年,在人工关节置换术住院总费用中,材料费的比重最大。影响人工关节置换术住院费用的因素有人工关节材料费比例、药品费比例、住院天数和主要诊断等。结论:控制人工关节的价格是降低人工关节置换术住院费用的关键,应积极探索手术治疗疾病的费用支付模式。

Objective： To provide suggestions for rational control of medical expenses, through analyzing the hospital charges and influencing factors of patients＇ joint prosthesis replacement medical insurance. Methods： Studying 525 patients with medical insurance, who were hospitalized in tertiary hospitals of Suzhou City from 2006 to 2009. These patients received the operation of total hip arthroplasty, total knee arthroplasty or femoral herd prosthetic replacement, and analyzing factors associated with hospital charges of the inpatients with stepwise multiple regression model. Results： From 2006 to 2009, materials expenses accounted for the highest proportion among medical charges. The major influencing factors include the proportion of implanting fee, the proportion of medicine fee, length of stay and primary diagnosis. Conclusion： Controlling the prices of joint prosthesis is crucial to reduce hospital charges for joint pros- thesis replacement. Great efforts should be made to explore the payment mode of surgical cases.