缺血性心脏病住院费用与住院日影响因素分析

The Analysis of Influencing Factors on Expenses and Days of Stay of the Ischemic Heart Disease

目的将北京市2007—2009年收治的缺血性心脏病的3个病种患者作为对象进行研究,以期为合理控制医疗费用提供决策依据。方法采用回顾性调查方法,用SPSS18.0统计软件,采用单因素统计方法对数据进行分析。结果研究结果显示,医院级别、付费方式、性别、年龄和治疗方式对平均住院日和例均住院费用有影响,2007—2009年缺血性心脏病的3个病种平均住院日呈下降趋势,手术费、治疗费和药费增长幅度较大。结论通过加强医院管理,完善双向转诊制度,推行DRGs,实施临床路径,根据病情选择适宜的治疗方式等措施,可实现缩短平均住院日、降低医疗费用的目的。同时要进一步提高医疗保障水平,降低患者自付比例,最大限度地减轻患者负担。

OBJECTIVE Study on the data of three common diseases in discharged patients in Beijing during 2007--2009 were collected and to make policy suggestions for controlling the medical expenses. METHODS Retrospection methodology was adopted, the data was analyzed by using univariate analysis of variance statistic approach with the software of SPSSS 18.0. RESULTS The factors influencing the average length of stay and the average hospitalization expenses included grade of hospital, payment mode, sex, age, reatment method. The average length of stay of three common diseases in discharged patients in Beijing during 2007--2009 shows a downward trend, the operation fee, treatment expense and the drug expenses has a large increases. CONCLUSION To realize shorten / average length of stay and decreased the medical expenses,some measurements should be taken such as strengthening hospital management,improving two-way referral system, implementing DRGs, implementing clinical pathways, choosing the appropriate treatment according to the condition of patients and so on. Meanwhile, it is also necessary to further improve the level of medical security, to decrease patient copayment and to minimize the burden of patients.