某皮肤病专科医院前10位病种住院费用及影响因素分析

Hospitalization expenses and influencing factors of the top ten diseases in a dermatology hospital

目的探讨广义估计方程(GEE)在皮肤病患者住院费用方面的应用,为合理控制皮肤病患者住院费用的过快增长提供科学指导。方法通过对广东省某大型三级皮肤病专科医院的2015-2019年5年住院患者病案数据进行单因素分析及GEE建模分析,探讨前10位病种费用情况及其影响因素。结果研究共纳入9588例患者数据进行实证分析,单因素分析显示性别、年龄、婚姻状况等11个因素对住院总费用的影响差异均有统计学意义(P<0.05),性别、年龄、婚姻状况等11个变量对住院天数的影响差异均有统计学意义(P<0.05)。GEE分析显示年龄、婚姻状况、是否医保、是否合并症、是否手术、是否使用抗菌药物、病例分型、病种类型是住院费用的影响因素(P<0.05)。结论手术、医保、病例分型是影响皮肤病患者住院费用的重要因素,应加强日间手术管理,推行按病组分值付费改革,从而降低皮肤病患者住院费用,减轻患者经济负担。

Objective To explore the application of generalized estimating equation(GEE)in hospitalization expenses of patients with dermatosis,and to provide scientific guidance for reasonable control of the excessive increase of hospitalization expenses of patients with dermatosis.Methods Univariate analysis and GEE modeling analysis were performed on the medical record data of inpatients in a large tertiary dermatology hospital in Guangdong Province from 2015 to 2019 to explore the costs of the top 10 diseases and their influencing factors.Results Totally 9588 patients were included in the study for empirical analysis.Univariate analysis showed that gender,age,marital status and other 11 variables had significant differences on the total hospita-lization costs(P<0.05),and gender,age,marital status and other 11 variables had significant differences on hospitalization days(P<0.05).GEE analysis showed that age,marital status,medical insurance,complications,surgery,use of antibiotics,case classification and disease type were the influencing factors of hospitalization expenses(P<0.05).Conclusion Surgery,medical insurance and case classification are important factors affecting the hospitalization expenses of patients with dermatosis.It is necessary to strengthen the management of day surgery and carry out the payment reform according to the score of disease groups,so as to reduce the hospitalization expenses of patients with dermatosis and reduce their economic burden.