某医院公费医疗患者住院费用统计分析

Statistical analysis of hospitalization expenses under flee medical service in a hospital

目的对某医院公费医疗患者住院费用的构成情况、药品费构成情况和住院费用分布等进行分析，探讨公费医疗患者住院费用上涨的原因及对策。方法应用SPSS13．0统计分析软件对某医院2004--2011年长期休养公费医疗患者住院费用的构成情况、药品费构成情况和住院费用分布进行分析处理。计数资料用绝对数及相对数表示，构成比间的比较采用，检验。结果某医院2004--2011年公费医疗患者住院费用中，药品费占87．12％，治疗费占4．11％，检查费占3．92％，材料费占3．49％，其它费占1．36％，可以看出药品费是住院费的主要组成部分。药品费中，西药费、成药费、草药费分别为61．51％，37．03％，1．46％。8年间人均药品费的平均增长速度为18．16％，定基比发展速度为321．67％。从住院费用分布情况看，住院费用主要集中在20000元以内，占总数的69．26％。50000元以上的患者人数占总人数的5．84％，费用占总额的23．16％。结论药品费是住院费用的主要组成部分且人均药品费增幅较高，存在很大的调控空间。药品费构成比例不合理，可充分利用中医独特优势增加草药费在药品费的比例，以实现控制药品费的目的。应关注高额住院费的问题，加强内部管理遏制不必要的高额消费。

Objective To analyze the composition and distribution of hospitalization expenses and the composition of medicine fees for those patients who enjoy free medical service, and to explore the factors which have influence on the rising of the expenses. Methods Statistical analysis software SPSS13.0 was used to process the data of the composition of hospitalization and medicine fees, as well as the distribution of the hospitalization charges of patients under free medical care who took a rest for a long time in a hospital from 2004 to 2011. The enumeration data was shown by absolute numbers and relative numbers, and comparison between the constituent ratios was tested by. Results Among the hospitalization cost of those patients who are under free medical care in a hospital from 2004 to 2011, medicine fees take 87.12%, treatment cost take 4. 11%, inspection fees 3.92%, material cost 3.49%, others 1.36%. As can be seen from the data, the major part is medicine charges, among which the percentages of Western medicine fees, patent medicine fees and herbal medicine fees are 61.51% ,37.03%, 1.46% respectively. The average rising speed of per capita medicine charges is 18.16% of the 8 years and the developing speed of the fixed base is 321.67%. Analyzing from the distribution of the medical fees, 69.26% of the total expenses are less than 20 000 per capita, while 5.84% of the patients had cost more than 50 000 per capita and used 23.16% of the total expenses. Conclusion Since medicine charges are the major component of hospitalization cost, and the per capita medicine charges have a higher increase, therefore, there is much room for regulation. In terms of the unreasonable constitution proportion of medicine fees, the unique advantage of traditional Chinese medical science should be applied to improve the proportion of herbal medicine fees in the total medicine cost so as to achieve the purpose of making medicine fees under control. Besides, the issue of high cost of hospitalization should be concerned and measures should be taken to strengthen the internal management and hold back unnecessary high consumption.