广西县级综合医院住院患者费用基本特征分析

Study on Hospital Expenditure and Influence Factors of County General Hospitals in Guangxi Province

目的通过对广西县级综合医院2011年出院患者费用分析,了解住院患者费用分布及特征,为政府和卫生部门控制医院医疗费用过快增长、推进新医改进程、解决群众"看病难、看病贵"问题提供数据支撑和决策依据。方法收集2011年广西县级综合医院住院病例676904例,采用SPSS19.0对其住院费用基本特征进行统计分析。结果广西县级综合医院住院病例较多的疾病为妊娠、分娩和产褥期,呼吸系统,损伤和中毒。不同疾病种类、医疗付款方式、入院情况、治疗结果的病例住院费用不同,住院费用随着住院天数增加而增加。住院总费用中药费比例过高现象严重。结论加强重点学科和优势专科的建设、加快重大疾病防控体系的建立;破除"以药补医"机制;缩短住院天数;加快医疗保险支付方式改革等是控制广西县级综合医院住院医疗费用的关键。

Objective This article focused on the constitution and characteristics of hospitalization expense among all patients of county general hospitals of Guangxi in 2011,in order to provide the government and health departments with factual,scientific basis to control unreasonable increase of medical costs,solve the problem of inadequate and expensive medical services,promote the new medical reform process. Methods Information of 676904 cases of hospitalized patients from tertiary municipal hospitals of Guangxi was collected and SPSS19. 0 statistics software package was used to analyze the structure of medical costs and main contributors related to medical costs. Results Through analysis,we found that the leading causes of hospitalization for patients were chronic non-communicable diseases and injuries. The total cost of hospitalization was related to the following factors： Days of hospitalization,Admission condition,Efficacy,Payment methods. But the largest cost share was drugs. Conclusion To strengthen the construction of the key disciplines and advantages of specialized subject; accelerate the system establishment of disease control and prevention; control the proportion of drugs consumables; to shorten the length of hospital stay; and to reform the mode of medical insurance payment are key points of controlling hospitalization expense.