建档立卡贫困户住院患者医疗费用因子分析

Factor Analysis of Medical Expenses of Registered Poor Households Hospitalized Patients

目的对建档立卡贫困户住院患者分类医疗费用进行因子分析。方法选取2018年1月1日-2020年12月31日在大同某市级三级医院住院的农村建档立卡贫困人口患者1363例作为研究对象,对患者分类医疗费用进行因子分析。结果住院分类费用占比由高到低依次是药品费(36.00%)、治疗费(14.80%)、材料费(12.90%)、化验费(12.60%)和检查费(11.04%)。3年住院日比较,差异无统计学意义(P>0.05);3年住院总费用比较,差异有统计学意义(P<0.05),其中3年住院分类费用中的化验费、检查费、诊查费、手术费、药品费和治疗费比较,差异有统计学意义(P<0.05);建档立卡贫困患者住院日、住院费用和医保费用均高于同期居民医保患者,自付费用低于同期居民医保患者(P<0.05);药物和治疗因子、手术材料因子和检查化验因子是影响建档立卡贫困户住院患者医疗费用的公因子。结论落实分级诊疗制度,合理使用药品和手术高值材料,推进检查化验结果互认可提升医疗保险资金的合理使用水平。

Objective To conduct factor analysis on the classified medical expenses of registered poor households hospitalized patients.Methods From January 1,2018 to December 31,2020,1363 rural registered poor households hospitalized patients in a tertiary hospital in Datong were selected as the research objects,and factor analysis was conducted on the classified medical expenses of patients.Results The proportion of hospitalization classification cost from high to low was drug cost(36.00%),treatment cost(14.80%),material cost(12.90%),laboratory cost(12.60%)and inspection cost(11.04%).There was no significant difference in 3-year hospitalization days(P>0.05).There was a statistically significant difference in the total cost of hospitalization in the three years(P<0.05).Among them,there were statistically significant differences in laboratory fees,examination fees,examination fees,operation fees,drug fees and treatment fees in the three-year hospitalization classification fees(P<0.05).The hospitalization days,hospitalization expenses and medical insurance expenses of poor patients with filing cards were higher than those of patients with residential insurance in the same period,and the out-of-pocket expenses were lower than those of patients with residential insurance in the same period(P<0.05).Drugs and treatment factors,surgical materials factors and test factors were the common factors affecting the medical expenses of inpatients in poor families.Conclusion The implementation of hierarchical medical system,rational use of drugs and high-value surgical materials,and promotion of mutual recognition of examination and laboratory results can improve the level of rational use of medical insurance funds.