新疆某三甲医院老年患者住院费用分析

An analysis of hospitalization expenses for elderly patients in a third class comprehensive hospital in Xinjiang

目的分析新疆某三甲医院2015年老年患者住院费用,研究住院费用影响因素,为科学降低患者直接医疗费用,提高医院效率提供理论参考。方法对收集到的某三甲医院老年住院患者信息进行统计学描述,分析其正序顺位前十病种的相关分布情况和住院费用分布情况,比较不同社会学特征、不同住院情况老年患者住院费用的差异,使用多元逐步回归方法来确定住院费用的影响因素。结果 (1)该院2015年各项住院费用占总住院费用构成比重较高的为西药费、材料费、化验费、检查费以及治疗费,依次为42.4%、16.3%、13.9%、13.3%、8.4%,5项费用占比和为94.3%。(2)前十病种中慢性缺血性心脏病(I25)、原发性高血压(I10)、未特指的糖尿病(E14)的住院费用较高,分别为3 805.9万元、1 654.9万元、1 271.8万元。(3)前十病种中均次费用较高的为慢性肾病(N18),均次费用为25 168.6元;不同社会学特征患者中,年龄≥80岁、男性、汉族、已婚患者均次费用较高,依次为17 995.7元、18 127.9元、16 571.6元、16 598.1元;不同入院情况患者中,急诊入院、1~3月入院、外科、住院次数>3次、非医保的患者均次费用较高,依次为19 748.8元、17 215.2元、20 409.8元、16 764.3元、16 779.7元。(4)多元回归结果显示,性别、年龄、入院途径、入院时间及入院科室均是影响该院老年患者住院费用的主要因素。结论建议医院可通过落实分级诊疗、强化门、急诊管理等措施来有效降低老年患者的住院费用。

Objective The hospitalization expenses of elderly patients in top three hospitals in Xinjiang in2015 were analyzed to study the influencing factors of hospitalization expenses in order to provide theoretical reference for scientifically reducing the direct medical costs and improving hospital efficiency.Methods Through the descriptive analysis of the collected information of elderly hospitalized patients in a top-three hospital,the distribution of the first ten diseases of positive sequence rankings and the distribution of hospitalization expenses were analyzed.The influencing factors of hospitalization expenses were determined using the multiple stepwise regression method.Results(1)In 2015,the cost of western medicine,materials,testing,inspection and treatment,were 42.4%,16.3%,13.9%,13.3%,8.4% respectively,which accounted for a large proportion of the total hospital expenses,and the above five expenses accounted for 94.3%.(2)The hospitalization costs of chronic ischemic heart disease(I25),essential hypertension(I10)and unspecified diabetes(E14)in the first ten diseases were higher,which were respectively 3 085.9 million yuan,1 644.9 million yuan,1 271.8 million yuan(3)In the top ten diseases,chronic kidney disease(N18)was the most highest average cost disease with the average cost of 25 168.6 yuan.Among the patients with different sociological characteristics,the cost of the patients aged 80 years and above,male,han,and married was higher,which was 17 995.7 yuan,18 127.9 yuan,16 571.6 yuan and 16 598.1 yuan respectively.Among the patients with different admissions,emergency admission,hospitalization from January to March,surgery and the inpatients hospitalized more than 3 times,and non-medical insurance patients had higher average cost,which were19 748.8 yuan,17 215.2 yuan,20 409.8 yuan and 16 764.3 yuan,16 779.7 yuan,respectively.(4)Multiple regression results showed that gender,age,admission approach,admission time and admission department were the main factors influencing the average cost of hospital stay.ConclusionIt is suggested that the hospital can effectively reduce the hospitalization expenses of elderly patients by implementing measures such as grading diagnosis and treatment,strengthening clinic and emergency management