优势学科不同亚专科同病种费用影响因素分析——以“取除骨折内固定装置”为例

Analysis of the Influencing Factors of Expenses for the Same Disease-Specific Treated in Different Subspecialties of Dominant Discipline:Taking “Removal of Internal Fixation Devices for Fractures” as an Example

目的分析公立医院优势学科不同亚专科相同病种的住院费用影响因素,探索提高病种管理水平的策略。方法以上海市某三级甲等综合医院骨科不同亚专科"取除骨折内固定装置"为例,以住院费用、日均住院费用为主要分析指标,通过多元回归分析探索主要指标与其他变量的关系。结果在住院费用和日均住院费用多元回归模型中,亚专科、手术部位和手术数均有显著影响。结论建议重视不同亚专科、不同手术部位病种管理的差异,搭建各亚专科交流的平台,探索合理缩短住院天数、管理提升与精细化管理的策略,以有效提升病种管理水平。

Objective To explore the influencing factors of the hospitalization expenses for the same disease-specific treated in different subspecialties of dominant discipline in a public hospital,and to explore the strategy of improving disease management level.Methods Through taking"removal of internal fixation devices for fractures"in a tertiary A comprehensive hospital in Shanghai as an example,hospitalization expense and average daily hospitalization expense are taken as the main analysis index.Multivariate regression analysis was used to explore the relationship between the main indexes with other variables.Results Subspecialties,surgical sites and number of operations all have significant impacts on hospitalization expense and average daily hospitalization expenses in multivariate regression analysis.Conclusion It is suggested to attach importance to the differences in the management of subspecialties and different surgical sites,build a communication platform for subspecialties,and explore strategies to reasonably shorten the length of stay,improve management and refine management,so as to effectively improve the level of disease-specific management.