广西某市综合医院高额住院费用分析

Analysis of the high hospitalization costs of general hospitals in a city of Guangxi

目的 分析高额住院费用的特征,找出其影响因素,为降低高额住院费用提供依据。方法 以95%分位数为依据,设定28000元为高额费用标准,收集了2016年广西某市县级及以上综合医院出院病例,筛选高额住院费用病例,按年龄、性别、疾病类别、医院等级等分析人均住院费用。统计分析采用SPSS17.0进行。结果 最终共纳入高额住院费用病例9999例。高额住院费用构成中,药费占32.92%,男性多于女性。不同年龄组、付费方式、疾病类型、住院天数、医院级别的住院费用差异有统计学意义(P<0.001)。医保类型住院费用由高到低依次为城镇职工医疗保险、城镇居民医疗保险、新农合。费用前三位疾病依次为呼吸系统疾病、循环系统疾病、肿瘤病例。三级医院的高额住院费用高于二级及以下医院。住院天数在120天以内,住院时间越长费用越高。结论 高额住院费用发生与性别、年龄、付费方式、疾病类型、住院天数、医院级别有关。

Objective To analyze the characteristics of high hospitalization costs and find out the influencing factors,so as to provide basis for reducing high hospitalization costs. Methods Based on 95% quartile,28 000 yuan was set as the high cost standard,discharged patients from general hospitals at the county level or above in a city of Guangxi in 2016 were collected,the cases with high hospitalization expenses were screened,and per capita hospitalization expenses were analyzed according to age,sex,disease category,hospital grade,etc.In addition,SPSS 17.0 was used for statistical analysis. Results A total of 9999 cases with high hospitalization costs were eventually included.Among the components of high hospitalization expenses,the cost of drugs accounted for 32.92%,and the costs of men were higher than those of women.There was statistically significant difference in hospitalization expenses among different age groups,payment methods,disease types,hospitalization days and hospital levels( P <0.001).The hospitalization expenses of medical insurance types from high to low were medical insurance for urban employees,basic medical insurance for urban residents and new rural cooperative medical system.The top three diseases of high hospitalization costs were respiratory diseases,circulatory system diseases and tumor cases.Hospitalization costs in tertiary hospitals were higher than those in secondary and lower hospitals.Within 120 days of hospitalization,the longer the hospitalization,the higher the cost. Conclusion The occurrence of high hospitalization costs is related to sex,age,payment method,type of disease,length of hospitalization and hospital level.