贫困白内障患者住院费用分析及控制策略:基于成都市天府新区的典型调查

Analysis of Hospitalization Expenses of Poor Cataract Patients and Control Strategy: Based on the Typical Investigation of Tianfu New District in Chengdu

目的分析贫困白内障患者住院费用特征,查找存在的问题,提出相应的控费策略。方法采用描述性统计和多元线性回归方法,分析成都市天府新区2014年至2015年1193例符合"百万贫困白内障患者复明工程"项目的白内障患者住院费用构成情况及影响因素。结果成都市天府新区贫困白内障患者住院费用(单眼4568.74元、双眼8758.17元)高于北京市和贵州省同级医院白内障患者住院费用;住院天数(单眼3.38d、双眼6.90d)超过国家规定的天数;住院费用中材料费比例最高(单眼51.74%、双眼53.83%),其次分别为手术费、药品费、检查费,而诊察费等其他费用的比例较低;住院天数是影响住院费用的最主要因素,且表现为正向相关性。结论白内障患者住院费用较高,结构不合理,导致国家和个人经济负担较重。实施白内障病种定额付费管理,推行白内障日间手术,规范人工晶体使用是降低白内障患者住院费用的有效途径。

Objective To analyze the characteristics of hospitalization cost of poor cataract patients,to find out the existing problems and put forward the corresponding control strategies. Methods The descriptive statistics and multivariate linear regression were used to analyze the composition and influencing factors of hospitalization expenses of 1193 cases of cataract patients in the project of ＂ millions of poor cataract patients＂ from 2014 to 2015 in Tianfu New District,Chengdu. Results The hospitalization cost of cataract patients in Chengdu Tianfu New District（ simple 4568. 74 yuan,double 8758. 17 yuan） was higher than that in the hospitals of the same level in Beijing and Guizhou Province. The number of hospital days（ simple 3. 38 d,double 6. 90d） exceeded the number of days stipulated by the state. The highest proportion of hospitalization expenses is material costs（ simple 51. 74%,double 53. 83%）,followed by the operation cost,inspection fees,medical expenses. The cost of other fees such as treatment fees is low. The number of hospital days is the most important factor affecting the cost of hospitalization which is in accordance with positive correlation. Conclusion The hospitalization cost of cataract patients is high and has an unreasonable structure,resulting in heavy national and personal economic burden. The management of fixed fee of cataract disease,the implementation of cataract surgery in the day,and the regulation of the use of intraocular lens are all the effective ways to reduce hospitalization cost of cataract patients.