2015年-2019年住院死亡患者住院费用影响因素分析

Analysis on Influencing Factors of Hospitalization Expenses of Hospitalized Patients Who Died in a Hospital from 2015 to 2019

目的通过统计2015年-2019年死亡患者性别、年龄、住院日、主要诊断排名前5位类目病种等基本情况,分析住院费用的相关因素及影响程度,为急危重症诊治、临终关怀的合理资源配置提供数据参考。方法运用卡方检验、方差分析比较死亡率、性别、年龄、住院日、住院次数等指标有无差异,分析住院费用的影响因素并作相关性,建立回归方程。结果2015年-2019年死亡率逐年升高(χ^(2)=13.743,P=0.008),男性患者死亡率为1.63%高于女性的0.81%,具有统计学意义(χ^(2)=128.490,P=<0.001)。5年间死亡患者年龄、住院次数、住院费用、药费、耗材费均有差异,P<0.05。建立住院费用的多元线性回归方程,影响因素年龄(岁)系数-15.971,P=0.039;住院日(天)系数111.712,P=<0.001;、药费(元)系数1.996,P=<0.001;、耗材费(元)系数1.379,P=<0.001。结论2015年-2019年死亡患者排名前5位类目病种分布变化不大,循环系统疾病、呼吸系统疾病、恶性肿瘤排名靠前,平均住院费用逐年上升,且与住院日、药费、耗材费成正比。建议医院合理配置医疗资源,加强对循环系统疾病、呼吸系统疾病、恶性肿瘤的学科建设,降低死亡率,分析住院费用构成及影响因素,科学控制药费、耗材费。

Objectives To describe the gender,age,hospital stay and top 5 diseases of death patients from 2015 to 2019,analyze the related factors and influence degree of hospitalization expenses,so as to provide data reference for the rational resource allocation of critical illness diagnosis and treatment and hospice care.Methods The chi-square test and analysis of variance were used to compare the mortality,gender,age,hospitalization days,number of hospitalizations and other indicators for differences,analyze the influencing factors of hospitalization expenses and make correlations,and establish regression equations.Results The mortality rate increased year by year(χ^(2)=13.743,P=0.008),and the ratio of male to female deaths was statistically significant(χ^(2)=128.490,P=0.000).There were differences in age,number of hospitalizations,hospitalization expenses,medicine expenses,and consumables expenses in 5 years,P<0.05.The multiple linear regression equation of hospitalization cost was established.The age(age)coefficient of the influencing factor was-15.971,P=0.039.The coefficient of hospitalization day(day)was 111.712,P<0.001;drug cost(yuan)coefficient 1.996,P<0.001;,consumable cost(yuan)coefficient 1.379,P<0.001.Conclusions The distribution of diseases in the top five categories of death patients from 2015 to 2019 had little change,with circulatory system diseases,respiratory system diseases and malignant tumors ranking top.The average hospitalization cost increased year by year,and was in direct proportion to hospitalization days,drug costs and consumables costs.It was suggested that hospitals rationally allocate medical resources,strengthen the discipline construction of circulatory system diseases,respiratory system diseases and malignant tumors,reduce the mortality rate,analyze the composition of hospitalization costs and influencing factors,and scientifically control the cost of drugs and consumables.