情感障碍伴或不伴重要躯体合并症住院治疗总费用的比较分析

Comparative Analysis of the Total Cost of Hospitalization for Affective Disorder with or without Major Somatic Complications

目的探讨情感障碍病例收治管理的经济学和社会学意义,分析比较DRG中TS11组和TS15组费用的差异,为DRGs分组提供依据。方法提取北京某三级甲等精神科专科医院2014年1月1日-2016年12月31日所有诊断为情感障碍出院患者病案首页信息9851份,按照是否伴有重要躯体合并症进行分组,其中TS11组388例,TS15组9463例。以住院总费用为因变量,利用回归分析的方法,分析DRGs组别、性别、年龄对2组费用差异的作用。结果 TS11组年龄较TS15组的年龄高,TS11组男性明显低于女性,随年龄增加男性比例增加。住院总费用受DRGs组别变量、年份变量、性别及年龄等交互项影响;年龄对住院费用的影响较大,TS11和TS15的费用差异随年龄变化呈现S型曲线;TS11组比TS15组住院总费用高2731.4元,2组住院治疗总费用有显著的差异。结论从客观的评价结果来看,综合医疗服务广度、难度及服务效率指标,TS11与TS15两组住院总费用差异明显,因此TS11与TS15两组的划分是合理的,具有临床和经济学意义。

Objectives To explore the economic and sociological significance of admission and management of patients with affective disorder, and analyze and compare the cost difference between TS11 group and TS15 group in DRGs, so as to provide basis for the grouping of DRGs. Methods From January 1 st, 2014 to December 31 st, 2016, 9,851 cases of discharged patients diagnosed as emotional disorders in a Three A and Tertiary Hospital in Beijing of psychiatric specialized were collected and grouped according to whether or not they were accompanied by significant somatic complications. Among them, 388 cases were in the TS11 group and 9,463 cases were in the TS15 group. With total hospital expenses as the dependent variable, the effects of DRGs group, gender and age on the cost differences between the two groups were analyzed by means of regression analysis. Results The age of TS11 group was higher than that of TS15 group, and the male of TS11 group was significantly lower than that of female. The total hospitalization cost was influenced by DRGs group variables, year variables, gender and age. Age had a great influence on hospitalization cost, and the difference between TS11 and TS15 in cost age showed an s-shaped curve. The total hospitalization cost of TS11 group was 2731.4 yuan higher than that of TS15 group. There was a significant difference in the total hospitalization cost between the two groups. Conclusions According to the objective evaluation results, the total hospitalization expenses of TS11 and TS15 groups were significantly different in terms of the breadth, difficulty and service efficiency of comprehensive medical services. Therefore, the classification of TS11 and TS15 groups was reasonable and of clinical and economic significance.