子宫肌瘤住院费用影响因素分析与研究

Analysis and Study about Influential Factors of Hospitalization Costs of Hysteromyoma

目的通过对子宫肌瘤手术患者住院费用影响因素的分析,探讨单病种定额付费管理的利弊,为单病种付费管理提供实证参考。方法收集某院2012年-2014年间子宫肌瘤按单病种定额结算的病例1631份,采用描述性分析、单因素方差分析、多元线性回归方法分析住院费用的构成及影响因素。结果单病种子宫肌瘤手术住院治疗费用构成中药品费比例最高(27.81%)、其次是手术麻醉费(26.60%)、材料费次之(25.41%)。多因素结果分析结果显示术式分组、手术麻醉费占比、材料费占比、药费占比、住院天数、手术范围、诊断数量与住院费用均显著相关。结论单病种限价付费是控制住院费用的有效手段。应制定合理的单病种限价标准并适时调整,推行DRGs预付模式,改革医疗服务价格体系,加强医院管理,切实解决"看病贵"的问题。

Objective To analyze the factors influencing the cost of in-patients with hysteromyoma operational patients. Explore the advantages and disadvantages of quota payment management as a single disease. Provide practical references for single disease limited price charge.Methods 1631 medical records of uterine leiomyoma were collected from the hospital from 2012 to 2014.The cases were payment-quota for single disease in medical cost.The statistical methods of descriptive analysis, ANOVA and multiple linear regressions were used to analyze the composition and influential factors of hospitalization costs. Results The highest percent of hospitalization expenses is drug costs（27.81%）, followed by operation and anesthesia cost（26.60%）, the third is material costs（25.41%）.Multivariate linear regression analysis showed that operational type, the ratio of operation and anesthesia fee,medicine ratio, medical material proportion, length of stay, range of operation and number of diagnosis were significantly related with cost. Conclusions Limited price charge of single disease is a way of controlling hospitalization costs effectively. To solve the problem of ＂high cost of getting medical service＂we should develop reasonable limited price of single disease and make timely adjustments, make use of DRGs prepay model, reform medical service price system, strengthen the management of hospital.