高倍率病例住院费用灰色关联及影响因素回归分析

Influencing factors on hospitalization expenses of high-rate cases based on grey correlation and regression analysis

目的探讨高倍率病例住院费用的影响因素,为进行有针对性的成本控制提供科学依据。方法选取宁夏回族自治区某三级甲等医院2018年79 929份出院病案首页数据进行DRG分析评价,以宁夏同级同类医院同一DRG组的平均住院总费用为标杆费用,计算各DRG组的标杆倍率,应用灰色关联分析法分析各DRG组各分项费用与住院总费用的关联度,应用logistic回归分析高倍率病例的影响因素。结果共有高倍率病例1 292例,占78 789例DRG入组病例的1.64%。灰色关联分析结果显示,10个高倍率DRG组中,药品费在6个DRG组中的关联序为第1位,耗材费在2个DRG组中关联序为第1位;logistic回归结果显示,年龄(P=0.010)、实际住院天数(P<0.001)、离院方式(P<0.001)为高倍率病例的影响因素。结论药品费、耗材费和住院天数对高倍率病例的住院费用影响较大,需重点关注。

Objective To investigate the influencing factors of hospitalization expenses in high-rate cases,and provide scientific basis for targeted cost control.Methods The first page data of 79929 discharged medical records of a tertiary hospital in Ningxia Hui Autonomous Region in 2018 were selected for DRG analysis and evaluation.The average total hospitalization expenses of the same DRG group in the same level and similar hospitals in Ningxia were taken as the benchmark cost to calculate the benchmarking ratio of each DRG group.GM grey correlation method was applied to analyze the correlation between each sub-item cost and the total hospitalization cost of each DRG group,and the logistic regression was used to analyze the influencing factors of high-rate cases.Results There were 1292 high-rate cases,accounting for 1.64%of 78789 DRG-incorporated cases.The results of grey correlation analysis showed that among the 10 high-rate DRG groups,the correlation order of drug cost in 6 DRG groups was the first,and that of consumables cost was the first in 2 DRG groups;logistic regression results showed that age group(P=0.010),actual hospital stay(P<0.001),and mode of leaving hospital(P<0.001)were the influencing factors of high-rate cases.Conclusions Drug costs,consumables costs,and length of stay have great influence on the hospitalization costs for high-rate cases,which should be paid particular attention to.