沈阳市某三甲医院糖尿病患者住院费用及影响因素分析

Analysis on the Hospitalization Expenses of Inpatients with Diabetes and Its Affected Factors in a Shenyang 3A Hospital

目的本研究对沈阳市某三甲医院2011-2013年糖尿病患者住院费用进行分析,并探讨其影响因素,为医疗保险制度的进一步改革和完善提供科学依据。方法从沈阳市城市居民基本医疗保险数据库系统中选取某三甲医院2011-2013年出院诊断为糖尿病的全部患者数据。采用描述性分析,秩和检验和多元线性回归等统计方法,分析住院费用构成及其影响因素。结果住院费用单因素分析显示,性别、年龄、医保类别、是否手术和是否输氧等特征的差异具有统计学意义。住院费用多元线性回归分析显示,住院天数、年龄、是否输氧、是否手术、性别和医保类别是住院费用的影响因素。结论有效控制医疗费用的快速增长应从合理控制住院天数着手,同时应进一步完善医疗保险制度,逐步将健康管理概念纳入支付范围。

Objective Through the study of the hospitalization expenses of inpatients with diabetes in a Shenyang 3A hospital during 2011 -2013 in order to probe its affected factors and provide scientific data to further reform and improve the medical insurance system. Methods The samples during 2011 - 2013 were drawn out from the date of Shenyang Provincial Medical Insurance Fund Center. The constitution of hospitalization expense and influent factors were analyzed by descriptive a- nalysis,Mann-Whitney U/Kruskal-Wallis H test and multinomial linear regression. Results All there were statistical signifi- cance of sex, age, medical insurance status, surgery or not and oxygen therapy or not by the rank sum test. Multinomial linear re- gression analysis showed that length of hospitalization, age, oxygen therapy or not, surgery or not, sex and medical insurance sta- tus impact on the hospitalization expenses. Conclusion Hospitalization days should be controlled to effectively slow the rapid growth of medical expense. Besides, it also should further improve the medical insurance system and gradually incorporate health management concept into pay limits.