多水平模型在患者住院费用影响因素分析中的应用

A Multilevel linear Model Analysis on Hospitalization Expense Influencing Factors

目的探讨某院患者住院费用的影响因素。方法利用某院2018年1月1日-2018年12月31日住院病案首页共97 462份,选取住院费用、住院天数、是否手术、手术级别、出院科室、病例分型、年龄、性别字段,应用多水平模型分析影响住院费用的因素。结果某院患者住院费用中位数为10 992.73元,住院天数中位数为6天,影响患者住院费用的主要因素有住院天数(T=11.449,P<0.001)、病例分型(P<0.001)、出院科室(Wald Z=3.909,P<0.001)等。结论住院天数是影响患者住院费用的最主要因素,其次为病例分型。医院在考虑患者疾病严重程度等前提下,应着力于缩短平均住院天数,合理利用卫生资源,减少患者经济负担,实现医院和患者的利益最大化。

Objective To investigate the hospitalization expense influencing factors.Methods The medical records of 97462 inpatients were collected in the hospital information system.Then selected the terms of hospitalization expense,stay length,operation condition,operation level,discharge department,severity,age and sex,and examined the hospitalization expense influencing factors by a multilevel linear model.Results The median of hospitalization expense is 10992.73,and the median of stay length is 6.The main hospitalization expense influencing factors includes:stay length(T=11.449,P<0.001),severity(P<0.001),discharge department(Wald Z=3.909,P<0.001),etc.Conclusion Under the premise of considering the inpatient’s severity,the hospital should focus on shortening the average stay length,reasonable use of health resources,reducing the financial burden on inpatients and maximizing the benefit for hospital and inpatient.