二级医院脑卒中患者医保住院费用调查及分析

Survey on the medical expenditure of insured patients with stroke hospitalized in second level hospitals

目的调查并分析二级医院脑卒中医保住院费用影响因素,探讨控制医保费用不合理增长的方法。方法回顾性分析3 930例脑卒中患者医保住院费用,对患者的一般情况及住院费用构成进行统计描述;采用单因素方差分析、t检验及多元线性回归分析住院费用影响因素。结果脑卒中住院费用中药费占45.78%,检查治疗费占40.79%,单因素分析显示出院转归(F=6.782,P=0.000)、住院日(F=983.866,P=0.000)与住院费用对数差异有统计学意义(P<0.05)。多因素分析显示出院转归(t=7.099,P=0.000)、住院日(t=43.566,P=0.000)与住院费用对数差异有统计学意义(P<0.05)。结论缩短住院日、降低药费、检查治疗费比例,充分发挥社区卫生服务机构的防病和慢病管理作用,降低医保住院费用不合理增长。

Objective To investigate the medical cost of insured patients hospitalized in second level hospitals due to stroke and to analyze the influencing factors in order to control the unreasonable growth of expenditure.Methods Retrospective analysis of 3 930 patients with patient＇s general condition and hospitalization cost structure statistical descriptive,using single factor variance analysis,t test and multivariate linear regression analysis in hospital cost factors.Results The cost of drugs accounted for 45.78% of total expenditure,and 40.79% of cost came from medical examination and treatment.Single factor analysis showed that the differences between the outcome after hospital discharge,days in hospitals and the medical cost were statistically significant（P0.05）.Multiple factor analysis revealed that there were also significant differences between the outcome of hospital discharge,days in hospitals and total medical cost（P0.05）.Conclusions In order to decrease the medical expenditure for insured patients hospitalized due to stroke,shortening the length of hospitalization and lowering the cost of drugs and treatment need to be considered.Meanwhile,community health centers should play important role in disease prevention and chronic disease management.