2014至2018年我国急性心肌梗死患者人均住院费用及其结构变动趋势研究

Study on the trends of per capita hospitalization expenses and structural changes of acute myocardial infarction patients in China from 2014 to 2018

目的分析2014至2018年我国急性心肌梗死(AMI)患者人均住院费用及其结构变动趋势,为优化医院住院费用结构提供参考依据。方法收集2014至2018年我国AMI患者人均住院费用相关数据,包括医药费、检查费、治疗费、手术费和卫生材料费。分析我国AMI患者人均住院费用的构成、人均住院费用结构变动值(VSV)和结构变动度(DSV)情况及各项费用对人均住院费用结构变动的贡献率。结果2014至2018年我国AMI患者人均住院费用逐年上升,从24706.0元上升至28889.2元;但医药费占比从22.14%降至15.70%,手术费用占比从11.40%上升至13.74%。2014至2018年我国AMI患者人均住院费用DSV为13.49%;2014至2018年医药费在人均住院费用中VSV最大(-6.44),且各时间段均呈负向变动;2014至2015年卫生材料费在人均住院费用中的VSV较大且为负值,呈负向变动;2014至2018年手术费用在人均住院费用中的VSV虽呈正向变动,但幅度较小。2014至2018年我国AMI患者医药费和卫生材料费对人均住院费用结构变动的贡献率较大,分别为47.74%、31.80%;2014至2015、2015至2016年卫生材料费贡献率最大,分别为63.08%、59.33%;2016至2017、2017至2018年医药费贡献率最大,分别为64.60%、47.64%;检查费、治疗费、手术费的贡献率均相对较小。结论医药费和卫生材料费仍是影响我国AMI患者人均住院费用上升的主要原因,但是医药费的占比率逐年下降,手术费用VSV逐年小幅度上升,可进一步优化我国AMI患者人均住院费用结构。

Objective To analyze the per capita hospitalization expenses and structural changes of acute myocardial infarction(AMI)patients in China from 2014 to 2018,in order to provide reference for optimizing the hospitalization expense structure of hospitals.Methods The per capita hospitalization expenses of AMI patients in China from 2014 to 2018 were collected,including medical expenses,examination expenses,treatment expenses,surgical expenses,and sanitary material expenses.The composition of per capita hospitalization expense,value of structure variation(VSV)and degree of structure variation(DSV)of per capita hospitalization expense,and the contribution rate of each expense to the structural change of per capita hospitalization expense of AMI patients in China were analyzed.Results The per capita hospitalization expenses of AMI patients in China have been increasing year by year from 2014 to 2018,from 24706.0 yuan to 28889.2 yuan;but the proportion of medical expenses had decreased from 22.14%to 15.70%;the proportion of surgical expenses had increased from 11.40%to 13.74%.The per capita hospitalization expenses DSV of AMI patients in China from 2014 to 2018 was 13.49%;the VSV was the largest in per capita hospitalization cost(-6.44)from 2014 to 2018,and all time periods showed negative change;the VSV of sanitary materials expenses in per capita hospitalization expenses was large and negative from 2014 to 2015,showed negative change;the VSV of surgical expenses in per capita hospitalization expenses showed positive change from 2014 to 2018,but the range was small.The contribution rates of medical expenses and sanitary materials expenses to the structural changes of per capita hospitalization expenses of AMI patients in China from 2014 to 2018 were the largest,which were 47.74%and 31.80%,respectively;the contribution rate of sanitary material expenses was the largest from 2014 to 2015 and 2015 to 2016,which was 63.08%and 59.33%respectively;the contribution rate of medical expenses was the largest in from 2016 to 2017 and 2017 to 2018,which were 64.60%and 47.64%,respectively;the contribution rate of examination expenses,treatment expenses and surgical expenses is relatively small.Conclusion Medical expenses and sanitary material expenses are still the main reasons for the increase in per capita hospitalization expenses of AMI patients in China.However,the proportion of medical expenses is decreasing year by year,and the VSV of surgical expenses is slightly increasing year by year,which can further optimize the per capita hospitalization expense structure of AMI patients in China.