江苏省老年女性五种大病住院费用及影响因素

The influencing factors of the hospitalization expenses of five kinds of patients with malignant tumor in Jiangsu province

目的探讨老年女性恶性肿瘤患者住院医疗费用的影响因素及恶性肿瘤费用控制并提出重特大疾病的医保支付管理建议。方法采用横断面研究方法。使用SPSS21.0软件,对某肿瘤医院60岁以上老年女性5种恶性肿瘤医疗费用影响因素进行回归分析。结果老年女性住院平均年龄67.11岁;平均住院天数18.77 d。5种恶性肿瘤住院费用主要影响因素为手术、医保、住院天数、年龄,不同疾病之间费用差异明显;经过回归处理,方程R^2=0.621,调整R2=0.618(P<0.05),可以解释61.8%费用变动情况。结论大病保险支付制度在一定程度上促进医保患者采取更为积极的治疗办法,在现行医疗保障制度下,推行以证据为基础的支付管理办法,建立医院绩效考核体系,从供方入手控费才能使制度走向可持续的发展道路。

Objective To explore the influencing factors of hospitalization expenses of the elderly female patients with malignant tumor, to explore the cost control of malignant tumor, and to put forward the suggestions on the management of medical insurance for major diseases. Methods The cross-sectional study method was used to investigate the influence factors of five malignant tumor medical cost of elderly women. Results The elderly female patients meanly aged of 67.11 years; the average hospitalization days were 18.77 days. Five malignant tumors hospitalized main factors were the cost of surgery, medical insurance, hospitalization days, age ; after regression, equation R2 =0.621, adjustment R2 =0. 618（P〈 0.05）, which could explain 61.8% cost changes. Conclusions Serious illness insurance payment system in a certain extent promote medicare patients to take a more aggressive treatment approach, under the current medical insurance sys- tem, implementing evidence based payment management measures.