医院综合改革背景下住院费用结构变动分析

Analysis on the Changes of Hospitalization Cost Structure under the Background of Hospital Comprehensive Reform

目的分析某三甲医院住院费用结构变动情况,为优化住院费用构成,实施DRG付费方式改革提供参考。方法收集山东省某三甲医院2015—2019年的住院费用数据,运用关联系数、关联度、结构变动值、结构变动度和结构贡献率等指标进行分析。结果该院住院费用结构变化显著,改革后卫生材料费占比超过药品费居于首位。灰色关联分析显示,关联度及关联序列排前三位的依次为卫生材料费(0.981)、药品费(0.838)和手术费(0.533)。2015—2019年该院住院费用总结构变动度为31.54%,药品费、手术费、治疗费和检查费累计结构贡献率达84.56%。结论该院药品费控制效果明显,但所占比重仍较高;改革后卫生材料费占比最高,需引起重视;检查费占比呈上升趋势;技术劳务费上调效果明显,但占比仍较低。

Objective:To analyze the changes of hospitalization expense structure in a hospital of class A and grade three,provide the references for optimizing the structure of hospitalization expense and implementing the reform of DRG payment method.Method:The inpatient cost data of a hospital of class A and grade three in Shandong Province from 2015 to 2019 were collected and analyzed by using correlation coefficient,correlation degree,structural change value,structural change degree and structural contribution rate.Result:The structure of hospitalization cost of the hospital changed significantly,and the proportion of health material cost exceeded that of medicine cost and ranked first after the reform.Grey correlation analysis showed that the top three items in terms of correlation degree and correlation sequence were the cost of sanitary materials(0.981),the cost of medicine(0.838)and the cost of surgery(0.533).From 2015 to 2019,the total structure variation of hospitalization cost in the hospital was 31.54%,and the cumulative structural contribution rate of drug cost,surgery cost,treatment cost and examination cost was 84.56%.Conclusion:After the reform,the proportion of health material cost is the highest,which needs to be paid attention to;the proportion of inspection fee shows an upward trend;the effect of technical service fee increase is obvious,but the proportion is still low.