某三甲医院住院患者费用构成与疾病构成分析

Analysis on Compositions of Inpatient's Expenses and Diseases in a Hospital of Class Three

目的通过分析不同付费方式住院患者的医疗费用与疾病构成,为有效控制医疗费用不合理增长,合理配置医疗资源提供依据,为评价医保支付方式改革与分级诊疗制度实施效果提供基线数据。方法从医院信息系统内调取2012—2015年住院患者费用与疾病数据,疾病数据按ICD-10国际疾病标准进行分类统计。结果 2012—2015年各年度不同付费方式住院患者人均费用(P<0.01)、人均药费(P<0.01)、人均检查费(P<0.01)、人均化验费(P<0.01)与人均材料费(P<0.01)的差异均有显著统计学意义。循环系统疾病、消化系统疾病、肿瘤与呼吸系统疾病均位列不同付费方式住院患者疾病构成顺位前5位。结论加强合理用药、合理用材的监督力度,促进分级诊疗工作实施,从而有效控制医疗费用不合理增长,合理配置医疗资源。

Objective： By analyzing inpatient＇s different payment for medical expenses and disease composition,to effectively control the irrational growth of medical expense,provide base-line data for reasonable medical resources allocation,and assess reform of medical insurance payment and practice effect of hierarchical diagnosis and treatment. Method： The authors retrieved data of inpatients and diseases in 2012-2015 from hospital information system,and made a classified analysis on the data with ICD-10 international disease standard. Result： There were significant differences in per capita expense of（ P〈0. 01）,per capita fees for drugs（ P〈0. 01）,per capita fees for examination（ P〈0. 01）,per capita fees for test（ P〈0. 01） and per capita fees for materials（ P〈0. 01） among inpatients with different payments in 2012-2015. Diseases of circulatory system,digestive system,tumor and respiratory system rank the top 5 diseases of patients with different payments. Conclusion： Monitoring rational uses of drugs and materials should be reinforced in order to promote hierarchical diagnosis and treatment,thus control effectively the irrational growth of medical expenses,and reasonably allocate medical resources.