某三甲医院剖宫产手术患者住院费用情况分析

Analysis of Hospitalization Costs of Patients with Cesarean Section in a Tertiary Hospital

目的分析剖宫产患者住院费用构成及其变化情况,为实施单病种费用控制提供科学依据。方法采用病例回顾法,收集某三甲医院2015年1月~2018年12月1831例剖宫产手术患者的临床资料,分析其基本信息、住院天数、住院费用等各类信息。结果剖宫产手术患者平均费用从2015年的7435.16元/人次增加到2018年的10865.81元/人次,平均增长速度为13.38%;诊断类、医用耗材类、手术治疗费、西药费,平均增长速度依次为18.73%、17.22%、8.83%、2.58%。2015~2018年剖宫产手术患者占分娩人数比例分别为47.24%、42.38%、39.72%、46.16%;剖宫产出院患者平均住院日呈逐年下降趋势。住院总费用随着住院天数的延长而上升,平均增长速度为9.03%,其中诊断类、西药费、医用耗材类费用、手术治疗费也呈上升趋势,平均增长速度依次为7.78%、6.62%、5.61%、3.14%。结论剖宫产手术住院总费用随住院天数的延长而增长。该院因积极调整医疗收费结构,合理控制西药费及医用耗材费用;合理运用临床路径,加强对医护人员规范化培训,在保证医疗质量的基础上缩短平均住院日和降低医疗成本。

Objective To analyze the composition and changes of hospitalization expenses for cesarean section patients,and provide scientific basis for the implementation of single disease cost control.Methods A case review method was used to collect clinical data of 1831 cesarean section patients from January 2015 to December 2018 in a third-level hospital,and analyze their basic information,length of stay,and hospitalization costs.Results The average cost of cesarean section patients increased from 7435.16 yuan per person in 2015 to 10865.81 yuan per person in 2018,with an average growth rate of 13.38%;the average growth rate of diagnostics,medical consumables,surgical treatment costs,and western medicine costs was sequentially They were 18.73%,17.22%,8.83%,and 2.58%.From 2015 to 2018,the proportion of cesarean section patients in childbirth was 47.24%,42.38%,39.72%,and 46.16%,respectively;the average length of hospitalization of patients in cesarean section hospitals showed a downward trend year by year.The total cost of hospitalization increased with the length of hospitalization,with an average growth rate of 9.03%.Among them,the costs of diagnosis,western medicine,medical supplies,and surgical treatment also increased.The average growth rates were 7.78%,6.62%,5.61%,3.14%.Conclusion The total cost of hospitalization for cesarean section increases with the length of hospital stay.The hospital actively adjusts the structure of medical fees,rationally controls the cost of western medicine and medical consumables;rationally uses clinical pathways,strengthens standardized training for medical staff,and shortens the average hospitalization day and medical costs while ensuring medical quality.