北京市护理院住院费用影响因素及付费方式探索性研究

The influencing factors of inpatients' charge and exploring the payment system in Beijing nursing home

目的:分析护理院患者住院费用的影响因素,探索适用于北京市护理院的付费方式。方法:对北京市护理院试点机构收治的96例住院患者进行问卷调查。结果:患者的认知功能状况、ADL分级和鼻饲情况是护理院住院费用的影响因素;以这3个因素为基础,采用决策树模型分析,将患者分为4个不同的资源利用分组,预测费用与实际费用的相对比为92.0%～97.5%。结论:根据资源利用程度,认知功能状况、ADL分级和鼻饲情况3个变量可将护理院住院费用有效分为4组。资源利用分组的付费方式适用于北京市护理院,便于更合理地利用和配置卫生资源。

Objective： To identify the influencing factors of inpatients＇ charge and to explore suitable payment system in Beijing nursing home. Methods： Questionnaires were used to investigate 96 patients in the pilot units of Beijing nursing home. Results： Patients＇ cognitive function, ADL and Nasal feeding tube were the influencing factors of nursing home inpatients＇ charge. Using Decision Tree analysis, all the patients could be divided into 4 different resource utilization groups based on these 3 variables. The relative ratios between estimated charge and the actual charge were 92.0 to 97.5 percents. Conclusion： Cognitive function, ADL and Nasal feeding tube can divide the patients into 4 groups according to their resource utilization. The Resource Utilization Group payment system is suitable for Beij!ng nursing home and is convenient for using and collocating medical resource. intelligently.