取消药品加成后某省级医院住院费用影响分析

Impact Analysis of Hospitalization Expenses in a Provincial Hospital After Cancellation of Drug Bonus

目的分析取消药品加成后,患者住院费用构成变化情况以及住院期间总费用、日均费用的主要影响因素,为医院决策提供参考。方法通过医院病案信息系统导出实施药品零加成政策后1年内住院患者病案首页相关信息,运用描述性分析、t检验、单因素分析、线性回归统计学方法分析。结果取消药品加成后,费用比例结构变化体现在药品、临床诊断项目占比下降,非手术治疗项目、检查用一次性耗材及手术/血费占比上调;多因素分析显示年龄、是否手术、住院天数、主要诊断类别为影响住院总费用及日均住院费用的主要因素。结论需进一步加强耗材精细化管理,通过人才技术引进、医护团队建设、优化绩效考核方案等方法,在降低患者负担的同时确保医院稳步健康发展。

Objective To analyze the changes in the composition of hospitalization costs of patients after the cancellation of drug additions,and the main influencing factors of total and daily costs during hospitalization,to provide a reference for hospital decision-making.Methods The relevant information of the first page of hospitalized patients'medical records within one year after the implementation of the zero-plus drug policy was derived through the hospital medical records information system,and analyzed by descriptive analysis,t test,univariate analysis,and linear regression statistical methods.Results After the cancellation of drug additions,the change in the cost ratio structure was reflected in the decline in the proportion of drugs and clinical diagnostic items,the increase in non-surgical treatment items,disposable supplies for inspection,and the proportion of surgical/blood costs.Multivariate analysis showed that age,whether surgery,length of stay,and main types of diagnosis are the main factors affecting the total cost of hospitalization and the average daily hospitalization cost.Conclusion It is necessary to further strengthen the refined management of consumables.Through the introduction of talents and technology,the construction of medical and nursing teams,and the optimization of performance appraisal programs,etc.,the hospital's steady and healthy development can be ensured while reducing the burden on patients.