2018年北京市住院患者费用及其影响因素研究

Path Analysis of Hospitalization Expenses and its Influencing Factors of Inpatients in Beijing in 2018

目的:探究北京市住院患者费用的主要影响因素,为合理控制住院费用、减轻住院患者的经济负担提供参考依据。方法:收集2018年北京市214家二级及以上医疗机构全部住院患者的病案首页数据,对患者的人均住院费用及住院天数进行描述性分析,并采用通径分析探究住院费用的影响因素。结果:569515例住院患者的平均住院费用的中位数和四分位数间距分别为14436.87元和19022.96元;人均住院天数的中位数和四分位数间距均为9天。通径分析结果显示,影响住院费用的最重要因素为住院天数(通径系数为0.571),疾病类型、并发症、入院途径、年龄、手术情况等因素不仅对住院费用存在直接作用,还可通过住院天数间接作用于住院费用。结论:住院天数是住院费用最重要的影响因素,通过合理缩短患者住院天数并加强对其他间接可控因素的控制,可有效减轻住院患者经济负担。

Objective:To explore the major factors influencing hospitalization expenses in Beijing,thus to provide evidence for control of hospitalization expenses and economic burden.Methods:Electronic medical records of inpatients were collected from 214 hospitals in Beijing in 2018.Path analysis was adopted to determine the risk factors of hospitalization expenses.Results:In total,569515 records were collected,and the median hospitalization expense was 14436.87 yuan with the interquartile range of 19022.96 yuan.The median length of stay was 9.0 days with the interquartile range of 9.0 days.Length of stay was the most important factor of hospitalization expenses with a path coefficient of 0.571,followed by principal diagnosis,complications,admission way,age,and operations.Conclusions:The length of stay is the most important factor of hospitalization expenses.Shortening the length of stay and controlling of related indirect factors may be effective to control the cost of hospitalization..