医疗卫生制度改革前后腹腔镜下食管裂孔 疝修补联合胃底折叠术患者住院费用的 比较

Comparative analysis on hospital expenses on the patients with laparoscopic repair of esophageal hiatal hernia combined with fundoplication before and after the healthcare reform

目的探讨医疗政策改革前后腹腔镜下食管裂孔疝修补联合胃底折叠术患者住院费用的差异,并分析其住院费用结构的改变,为提出相应对策及建议提供依据。方法回顾性分析2016年5月至2019年3月日,新疆某三级甲等医院行食管裂孔疝修补术患者资料,出院时间以2017年10月1日为界限进行分组,医疗卫生制度改革前患者51例(A组),医疗卫生制度改革后患者55例(B组),分析比较2组患者各项目费用的差异。结果食管裂孔疝手术患者在医改后的一般医疗服务费、护理费、非手术治疗费、手术治疗费、麻醉费高于医改前,差异有统计学意义(P<0.05);西药费、影像学诊断费、检查用材料费、手术用材料费低于医改前,差异有统计学意义(P<0.05);医改前后的费用结构改变明显,差异有统计学意义(P<0.05)。结论基于医改政策,有效的改变医改前后医疗费用的结构,可使手术住院患者各项目费用分配更合理。

Objective To explore the difference of hospitalization expenses of patients with esophageal Laparoscopic repair of esophageal hiatal hernia combined with fundoplication before and after the reform of medical policy,and to analyze the change of hospitalization expenses structure,so as to provide the basis for the corresponding countermeasures and suggestions.Methods The data of patients undergoing esophageal Laparoscopic repair of esophageal hiatal hernia combined with fundoplication in hospital from May 10,2016 to March 31,2019 were retrospectively analyzed.The discharged time was divided into groups based on October 1,2017.The former was 51 cases(Group A)and the latter was 55 cases(Group B).The differences of project costs between the two groups were analyzed and compared.Results The general medical service fee,nursing fee,non-surgical treatment fee,operation treatment fee and anesthesia fee of patients with esophageal hiatal hernia after medical reform were higher than those before medical reform,and the difference was statistically significant(P<0.05).The cost of Western medicine,imaging diagnosis fee,examination material fee and operation material fee were lower than those before medical reform(P<0.05).There was statistical significance(P<0.05).Conclusion Based on the medical reform policy,the structure of medical expenditure before and after the medical reform can be effectively changed to make the cost allocation of surgical inpatients more reasonable.