单病种住院费用分析及绩效管理模式探讨--以结直肠癌手术为例

Analysis of Hospital Expenditure and Discussion on Management Mode of Single Disease:Take Colorectal Cancer Surgery for Instance

目的分析单病种住院费用的构成比例,探索影响住院费用的主要因素。方法以结直肠癌手术为研究对象,采用回顾性调查研究方法,收集上海某三甲医院2013年1月—2014年12月间,主诊断为结直肠癌并行手术的出院患者的病案首页信息。采用单因素和多元回归对住院总费用的影响因素进行分析。结果在单病种住院费用的构成中,医用耗材费占比最高,其次为药费、治疗费,护理费占比较低;影响单病种住院费用的主要因素有住院天数、手术方式和疾病转归情况。结论单病种住院费用构成不合理,医院应进一步加强单病种质量管理,提高医疗质量。

Objectives To investigate the constitution of the hospital expenditure with the single disease and explore the influencing factors.Methods The information of home page of medical records of the patients with colorectal cancer in one of the grade-one class-three hospitals in Shanghai between January 2013 and December 2014 was retrospectively analyzed.Single factors and multiple regression analysis were done to analyze the influencing factors of the hospital expenditure.Results The hospital expenditure of patients with colorectal cancer was mainly constituted by medical consumables fee and medicine fee.The treatment charge and nursing charge ranked the lowest.The length of stay,surgical methods and the type of medical insurance were the main influencing factors of hospital expenditure.Conclusions Putting forward some suggestions of controlling medical expense in order to strengthen the quality management of single disease and provide some references for the performance appraisal based on single diseases.