上海市产妇住院分娩费用影响因素分析

Analysis on influencing factors for cost of hospital delivery in Shanghai

目的·分析产妇住院分娩费用的结构及其影响因素,为合理控制住院分娩费用过快增长提供理论依据。方法·采用分层随机抽样的方法,选取上海市12家二级、三级医院,按照住院号随机抽取2016年1月1日—2016年6月30日分娩的产妇病案,调取基本信息及住院期间费用。整理数据并建立数据库,运用SPSS 20.0软件进行描述性统计、z检验、非参数检验、多元线性逐步回归分析。结果·上海市2016年1月—6月产妇人均住院分娩费用为7 826.39元,其中床位费、检查费、手术费、西药费在费用明细中占比较高,依次约为17%、16%、15%和15%。产妇住院费用单因素分析显示,年龄、职业、支付方式、有无妊娠合并症、分娩方式、住院天数、有无产时及产后病理状况对住院费用的影响有统计学意义。产妇住院费用多因素研究显示,影响住院分娩费用的主要因素包括分娩方式、住院天数、有无产时及产后病理状况、年龄、有无妊娠合并症。结论·剖宫产的住院费用显著高于阴道分娩,剖宫产与阴道分娩住院费用构成不同,降低剖宫产率具有重要意义。优化产妇住院费用结构,应从控制西药费、手术费、检查费等方面着手。

Objective·To analyse the composition of hospitalization childbirth costs and its influencing factors,which provides theory basis on reasonable control of rapid growth of hospitalization childbirth costs.Methods·With the method of stratified random sampling,12 secondary and tertiary hospitals were chosen in Shanghai.According to the hospitalization number,the maternal disease cases delivering from Jan.1,2016 to Jun.30,2016 were randomly selected.The basic information and the cost of hospitalization were collected,and the database was established.Descriptive statistics,z test,non-parametric test and multiple linear stepwise regression analysis were performed by SPSS 20.0.Results·The cost of hospital delivery per capita in Shanghai from Jan.to Jun.2016 was 7 826.39 yuan,of which the cost of bed,inspection,operation and western medicine accounted for the highest proportion of the expenses(17%,16%,15%and 15%,respectively).Maternal hospitalization cost univariate analysis showed that the effect of age,occupation,payment,pregnancy complications,modes of delivery,length of stay,prenatal and postnatal pathological condition on hospitalization cost were statistically significant.A multifactorial study on the cost of hospitalization showed that the delivery mode,length of stay,prenatal and postnatal pathological pathological condition,age and pregnancy complications were the main influencing factors.Conclusion·The hospitalization cost of cesarean section is significantly higher than that of vaginal delivery,the hospital cost structure of these two modes of delivery is different,and the reduction of cesarean section rate is of great significance.It is necessary to optimize the hospital cost structure via controlling the cost of western medicine,operation,and inspection.