2015年-2021年某院老年患者住院费用影响因素分析

Analysis on Hospitalization and Cost Influencing Factors of the Elderly in a Hospital from 2015 to 2021

目的分析北京市城市副中心某三级综合医院老年患者住院费用状况及影响因素,为实施老龄化社会办医政策提供参考依据。方法调取2015年1月1日至2021年12月31日60岁以上住院患者的住院病案首页,采用一般描述性分析总结159646例患者的基本情况,单因素分析方法评估群体间差异,多重线性回归方法分析住院费用的影响因素。结果老年住院患者次均住院费用24734元,住院费用的中位数随年龄的增大而增多。多重线性回归结果显示,性别(=-0.043,P<0.001)、住院次数(=-0.148,P<0.001)、年份(=0.006,P<0.001)、住院天数(=0.087,P<0.001)、支付方式(=0.658,P<0.001)、治疗方式(=-0.083,P<0.001)、离院方式(=0.088,P<0.001)均是住院费用的主要影响因素。结论老年患者次均住院费用呈上升趋势,控制住院费用的上升应成为相关部门干预的重点。

Objectives The inpatient expenses of elderly patients in a tertiary general hospital of Beijing Municipal Sub-center were analyzed and the influencing factors were analyzed to provide reference for the medical policy of the aging society.Methods From January 1st,2015 to December 31st,2021,the front page of hospitalized medical records of patients over 60 years old were collected.General descriptive analysis method was used to summarize the basic information of 159,646 patients.Univariate analysis method was used to evaluate the differences between groups,and multiple linear regression method was used to analyze the influencing factors of hospitalization expenses.Results The average cost of hospitalization was 24734 yuan,and the median cost of hospitalization increased with the increase of age.Multiple linear regression results showed that gender(=-0.043,P<0.001),number of hospitalizations(=-0.148,P<0.001),year(=0.006,P<0.001),length of hospitalization(=0.087,P<0.001),payment method(=0.658,P<0.001),treatment mode(=-0.083,P<0.001)and discharge mode(=0.088,P<0.001)were the main influencing factors of hospitalization costs.Conclusions The average inpatient cost of the elderly was on the rise tendency.Controlling the rise of inpatient cost should be the focus of relevant departments'intervention.It was suggested that medical institutions should shorten the length of hospitalization,improve graded diagnosis and treatment,and strengthen the construction of specialty.Health authorities would take comprehensive measures such as reforming payment methods and improving social security to jointly adapt to the challenges brought by an aging society.