徐州市某三甲医院2014—2018年死亡病例住院费用分析

Analysis on Hospitalization Costs of the Death Cases in a Hospital in Xuzhou from 2014 to 2018

目的了解死亡患者的住院费用情况及其影响因素。方法收集徐州市某三甲医院2014—2018年住院死亡患者资料,以国际疾病分类(ICD-10)标准进行分类,使用Kruskal-WallisH检验和Mann-Whitney U检验进行住院费用分析。结果2014—2018年徐州市住院死亡患者人数呈递减趋势,住院天数中位数(χ2=66.104,P<0.01)、人均费用中位数(χ2=68.797,P<0.01)和日均住院费用中位数(χ2=276.547,P<0.01)呈上升趋势。不同年龄、性别、不同系统疾病的住院天数中位数(χ2=171.661,P<0.01)(Z=-3.392,P<0.01)(χ2=215.43,P<0.01)、人均费用中位数(χ2=487.8,P<0.01)(Z=-4.883,P<0.01)(χ2=490.88,P<0.01)、日均费用中位数(χ2=242.93,P<0.01)(Z=-3.743,P<0.01)(χ2=471.681,P<0.01)差异有统计学意义。结论住院死亡患者的医疗资源存在过度使用和资源浪费,对合理的医疗费用使用和医疗资源的配置应给予更多的关注,以减轻住院患者的费用负担,保障医疗资源使用的公平性。

Objective To figure out the hospitalization expenses and relevant influencing factors in hospitalized death cases.Methods The data of hospitalized death cases in a hospital in Xuzhou City from 2014 to 2018 were collected and classified by the International Classification of Diseases(ICD-10).Their hospitalization costs were analyzed using Kruskal-Wallis H test and Mann-Whitney U test.Results The number of hospitalized death cases in Xuzhou City showed a decreasing trend from 2014 to 2018,while an upward trend was shown in the number of the median hospitalization days(χ2=66.104,P<0.01),the median hospitalized expenses(χ2=68.797,P<0.01)and the median daily average hospitalization expenses(χ2=276.547,P<0.01).The number of the median hospitalization days(χ2=171.661,P<0.01)(Z=-3.392,P<0.01)(χ2=215.43,P<0.01),the median hospitalized expenses(χ2=487.8,P<0.01)(Z=-4.883,P<0.01)(χ2=490.88,P<0.01),and the median daily average hospitalization expenses(χ2=242.93,P<0.01)(Z=-3.743,P<0.01)(χ2=471.681,P<0.01)varied significantly with different ages,genders,and different systemic diseases.Conclusion Medical resources for hospitalized death cases were overused and wasteful,so more attention should be paid to the rational utility of medical expenses and the allocation of medical resources,so as to reduce the cost burden of hospitalized patients and to ensure the fairness in the utility of medical resources.