新农合患者住院费用影响因素研究——基于陕西省子长县调查数据

Study on influencing factors of the cost of inpatients participating in New Rural Cooperative Medical System——Based on the data from Zichang county in Shanxi province

[目的]揭示新农合患者住院费用总量、结构的影响因素及其影响程度,提供降低新农合患者住院费用、调整住院费用结构的对策。[方法]以陕西省子长县2013年新农合患者住院费用为研究对象,应用二元Logistic回归模型和多元线性回归模型分析新农合患者高额住院费用以及住院费用结构的影响因素。[结果]医院等级、是否手术和住院天数对高额住院费用的产生具有影响;同时医院等级、住院天数、是否手术和年龄对药材占比、检验占比以及服务占比具有不同程度的影响。[结论]可以通过引导患者分级诊疗,严格规范手术指症以及科学缩短住院天数来控制高额住院费用;通过合理降低药材费占比,有效控制检验费占比以及适度提升服务费占比调整住院费用结构。

Objective To reveal the influence factors and degree of total cost and structure of inpatients participating in New Rural Cooperative Medical System （NRCMS）, to provide countermeasures to reduce the hospitalization expenses and adjust it＇ s structure. Methods Took hospi- talization expenses of NRCMS inpatients in Ziehang county in 2013 as the research objects, used binary logistic regression model and muhiple linear regression model to analyze the influence factors of high hospitalization expense and hospitalization fee structure. Results The level of the hospital, surgery or not and hospitalization days had the influence on high hospitalization expense. At the same time, the hospital grade, hospi- talization days, surgery or not and age had different degree of influence on medicinal material, inspection and service charge propor- tion. Conclusions Control high hospitalization expense through guiding patients hierarchical diagnosis treatment, regulating operation indication and shortening the hospitalization days scientifically. Adjust hospitalization fee structure through reducing medicine material fee proportion, con- trolling inspection fee proportion and increasing service charge proportion.