住院次均费用的灰色关联及结构变动度分析

The Grey Correlation and Structural Variation Analysis of the Average Cost of Hospitalization

目的 分析某医院住院次均费用的结构变化,为合理控制住院患者费用上涨提供数据参考。方法收集2013年1月1日-2020年12月31日共8年668611例住院患者的住院费用构成数据,以年度为单位计算住院患者次均费用,用灰色关联法和结构变动度法分析住院患者费用的关联程度、结构占比及变动情况。结果 住院次均费用从2013年到2020年增长了6080元(35.48%),其中材料费增长最多,药品费用逐年下降,至2020年降至27.23%。灰色关联度分析显示,治疗费与住院费用的关联度最大为0.9,材料费第1为0.89;结构变动度分析结果显示,住院次均费用项目中结构变动贡献率最高为药品费(46.57%)、材料费第2为15.59%,治疗费、手术费、诊疗费及护理费的贡献率较小,合计13.62%。结论 材料费是影响住院次均费用及结构变动的首要因素,应重点管控;检查费和检验费是是影响患者住院次均费用变动的重要因素,应重点管控;目前对药品费的管理效果较好,应继续保持。应积极推动医院内部费用管理,建立动态的价格调整机制,适当提升医疗服务价格。

Objectives This study aims to analyze the structural changes in the average cost of hospitalization in a hospital and provide data reference for reasonable control of the rising cost of inpatients.Methods The data on the composition of hospitalization expenses of 668 611 inpatients in 8 years from January 1, 2013 to December 31, 2020were collected. The average cost of inpatients was calculated on an annual basis.The grey relational method and the structural variation method were used to analyze the relational degree, structural proportion, and variation of inpatient expenses. Results The average hospitalization expense increased by 6,080 yuan(35.48%) from 2013 to 2020, of which the cost of materials increased the most. The cost of drugs decreased year by year, to 27.23% in 2020. The grey correlation degree analysis showed that the highest correlation degree between treatment costs and hospitalization costs was 0.9, and the second was 0.89 for material costs. The results of the structural change analysis showed that the highest contribution rate of structural change in the average hospitalization cost was drug cost(46.57%), and the second material cost was 15.59%. The contribution rate of treatment fee, operation fee,diagnosis and treatment fee, and nursing fee is smaller, totaling 13.62%.Conclusions The cost of materials is the primary factor affecting the average hospitalization expense and structural changes, which should be controlled.Inspection fees and laboratory fees are important factors that affect the change in the average hospitalization expense and should be controlled. The management of drug costs is currently effective and should be maintained. It is necessary to actively promote the hospital to establish a dynamic price adjustment mechanism, and appropriately increase the price of medical services.