新型农村合作医疗脑梗死住院患者医疗费用差异分析

Analysis on differences of hospitalization costs for cerebral infarction patients under new rural cooperative medical system

目的分析脑梗死住院患者的医疗费用差异情况,提出相关政策建议。方法采用回顾性调查方法对脑梗死患者的住院费用进行研究,运用统计软件SPSS17.0对住院数据进行描述性分析、方差分析和t检验。结果脑梗死住院患者的平均费用为6 317元,实际补偿比为75%,男性(54.2%)多于女性(45.8%),平均年龄(64.1±11.4)岁,以60岁(71.9%)及以上为主;主要集中在县内、公立医疗机构就医(83.3%,77.5%),支付方式以单病种付费为主(76.9%);脑梗死住院患者的住院费用、补偿费用和自付费用在不同年龄段、不同就医地点、不同所有制医疗机构、不同支付方式下差异均有统计学意义(P<0.05)。结论加强对农村老年人慢性病的健康教育;提升县内医疗机构诊疗能力,落实双向转诊制度;规范民营医疗机构管理,强化民营医疗机构的社会责任感;积极推进单病种支付方式的全面实施。

Objective To analyze differences of hospitalization costs for cerebral infarction patients and provide the basis for developing policies and measures. Methods Retrospective survey research method was used to study inpatient hospitalization expense,the hospitalization data were analyzed through the descriptive analysis,ANOVA statistic and t-test by SPSS17. 0. Results The average hospitalization costs was RMB 6,317,the actual compensation ratio was 75%,males（ 54. 2%） higher than females（ 45. 8%）,average age was 64. 1 ± 11. 4. Patients concentrated in more than 60 years older.The patient were mainly treated in the county-level and public medical institutions（ 83. 3%,77. 5%）,the major mode of payment was that quota for single disease payment（ 76. 9%）,the hospitalization costs of patients with cerebral infarction,compensation fees and out of pocket expenses in different ages,different location,different ownership hospitals diffenrent payment had statistical significance（ P 0. 05）. Conclusion It should strengthen health education and tertiary prevention in the rural population; improve the treatment capacity of primary medical institutions and enforcement of two-way referral system,standardize the management of private medical institutions,strengthen the sense of social responsibility of private medical institutions,actively promote the full implementation of single disease payment methods.