辽宁省八家县医院脑梗死住院患者费用分析

Analysis of the Hospitalization Expense for Cerebral Infarction Patients in Eight County Hospitals in Liaoning Province

以辽宁省各市县中心医院为研究对象,收集ICD编码相对较为完善的八家县医院脑梗死临床数据,应用SPSS统计软件,对辽宁省八家县级医院脑梗死住院患者的住院费用进行分析,采用百分位数法和决策树模型将脑梗死费用分为高中低三层并进行探讨,用多元线性回归方法寻找出住院费用影响因素。结果显示辽宁省八家县级医疗机构间脑梗死医疗费用差异较大,影响医保支付的公平性。住院天数、入院途径、糖尿病、肺内感染、高血压以及年龄是费用的主要影响因素,有8.2%的病例没有任何并发症却出现在高费用组,应加强医疗服务行为监管,确保新农合基金的合理使用。

Hospitalization expenses for cerebral infarction patients in eight county hospitals in Liaoning province were collected and analyzed using the SPSS statistical software. All patient data from hospitals were aggregated and hospitalization expenses were divided into three categories based on percentile.Disease characteristics for each expense category were assessed by using the decision tree model to understand the differences in expenses;and these factors were assessed for significance by using the step-wise multiple linear regression.Expense categories were compared by hospitals.Hospitalization expenses for cerebral infarction patients in eight county hospitals were significantly different.The hospital with the lowest average expense was half the cost of the hospital with the highest average expense.Days of hospitalization,admission way,diabetes mellitus,intrapulmonary infection,hypertension,and the age are the main factors for hospitalization expenses.About 8.2% of the cases without any complication appear in the high cost group.The government should strengthen the supervision of medical service behavior.At the same time improve the ICD coding,and strengthen the construction of hospital information system.