采用主成分回归法分析住院次均费用影响因素

Analysis of the Influence Factors of Average Hospitalization Expense by Principal Component Regression Method

目的分析住院次均费用影响因素,为控制住院费用不合理增长提供参考依据.方法选取2018年1月1日-2018年12月31日某三甲医院住院次均费用为研究对象,对10项指标采用主成分分析法提取主成分,通过多元线性回归分析各指标对住院次均费用的影响.结果主成分分析法提取3个主成分,累积方差贡献率为73.857%,多元线性回归方程有统计学意义(F=26.769,P<0.001),复相关系数R=0.785,决定系数R2=0.616.危急入院占比和死亡人数对住院次均费用的影响最大,与其成正相关;其次是药占比和住院日大于30天患者数,与其成正相关;病床周转次数、平均住院日、出院人次、完成率、入径率和术前平均住院日均对其有一定的影响.结论危急入院占比、死亡人数、药占比、住院日大于30天患者数是住院次均费用的主要影响因素.三甲医院应重点提升疑难危重患者救治质量,改善医疗服务质量,加强医疗服务效率管理,有助于控制住院费用增长.

Objective To analyze the influence factors of average hospitalization expenses,in order to provide reference evidence for control the unreasonable increase of hospitalization expenses.Methods The average hospitalization expense of a Tertiary A Hospital from January 1,2018 to December 31,2018 was selected as the research object.Principal components were extracted from 10 indicators by principal component analysis,and then multiple linear regression analysis was used to analyze the influence of each index on the average hospitalization expense.Results Three principal components were extracted by principal component analysis,the cumulative variance contribution rate was 73.857%,the multiple linear regression equation had statistic significance(F=26.769,P<0.001),which had multiple correlation coefficient as 0.785,and determination coefficient as 0.616.The proportion of critical admissions and the number of deaths had the biggest impact on the average hospitalization expenses and positively correlated respectively.Secondly,the proportion of drugs and the number of patients hospitalized for more than 30 days were positively correlated.The turnover times,average length of stay,the number of discharge patients,completion rate,admission rate and preoperative stay in bed had certain influence on the average hospitalization expenses.Conclusion The proportion of critical admissions,the number of deaths,the proportion of drugs and the number of patients hospitalized for more than 30 days were the main influence factors of the average hospitalization expenses.The Tertiary A Hospital should focus on promote the quality of treatment for difficult and critical patients,improve the quality of medical services,and strengthen the efficiency management of medical services,so as to help control the growth of hospitalization costs.