糖尿病患者住院费用及影响因素的通径分析

Analysis on the Hospitalization Expenses and Influencing Factors for Diabetic Patients

目的:探讨糖尿病患者住院费用的主要影响因素,为减轻患者疾病经济负担、进一步控制医疗费用过快增长提供理论和现实依据。方法:采用描述性统计和通径分析研究3 306例糖尿病患者住院费用的影响因素。结果:3 306例糖尿病患者住院费用人均8 665.97元,中位数7 715.68元;住院日人均14.11天,中位数14.00天。住院总费用及日均费用逐年上升,药品类费用仍处于主导地位。住院日是住院费用的最主要影响因素,其他因素包括年龄、婚姻状况、付费方式、药占比、入院情况、疾病类型、是否手术、有无并发症别和出院时间,并且通过住院天数间接影响住院费用。结论:住院日是住院费用的最主要影响因素,控制住院费用要以控制、缩短平均住院日为突破口,加强对可控因素的控制,采取综合措施,以有效缓解费用的过快增长。

Objective： To analyze the major factors influencing hospitalization expenses for diabetes patients, aiming at providing a basis to adjust the current high medical expenses and reduce patients＇ economic burden. Methods： Medical and billing records of 3 306 diabetes patients who received treatments in tertiary hospitals in 2013-2016 were obtained based on descriptive stastics and path analysis. Data on hospitalization expenses were subjected to pathway analysis. Results： For the 3 306 patients analyzed, the average total medical expenses was 8 665.97 yuan with a median of 7 715.68 yuan. The average hospital stay was 14.11 days with a median of 14.00 days. The total cost of hospitalization and the average daily expenses increased by yeas, and the medical expenses were still in the leading position. Hospital stay was the most important influencing factor of hospitalization expenses. Other factors included Age, marital status, payment methods, drug proportion, admission condition, type of disease, surgery, complications and discharge time. Conclusion： Length of hospital stay was the most important determinant of hospitalization expenses. Shortening hospital stay and strengthening the control of controllable factors could be considered as a potential comprehensive measure to lower the high hospitalization expenses.