黑龙江省某三级医院城镇职工医保老年患者住院费用及其影响因素分析

Analysis of hospitalization expenses and influencing factors for elderly patients with medical insurance for urban employees in a tertiary hospital in Heilongjiang province

目的:通过对黑龙江某三级医院参加城镇职工医保的年龄在60岁以上老年住院患者的住院费用分布及其影响因素分析,探讨参保老年住院患者费用变动的影响因素,为医疗管理提供理论参考。方法:通过医院HIS系统,收集整理2014年1月1日至2022年11月30日期间住院的参加城镇职工医保的60岁以上的老年患者的住院病案首页和明细账单基本信息,通过SPSS29.0软件,采用非参数检验比较不同住院患者群体住院费用的差异、多元线性回归分析住院总费用的影响因素。结果:住院天数(t=54.948,P<0.001)、年龄(t=12.911,P<0.001)、疾病类型(t=7.618,P<0.001)老龄化直接医疗经济负担的影响因素。结论:应加强费用构成监管,稳步推进分级诊疗模式,更好利用基层医疗机构,改善服务条件、医疗服务管理和医疗资源利用,减轻患者和社会经济负担,同时继续完善基本医疗保险制度,探索建立基于不同病种的付费方式。

Objective:To analyze the distribution and influencing factors of hospitalization expenses for elderly inpatients participating in urban employee medical insurance in a tertiary hospital in Heilongjiang,and to explore the influencing factors of changes in hospitalization expenses for insured elderly inpatients,providing theoretical reference for medical management.Method:Collect and organize the basic information of hospitalization medical records and detailed bills of elderly patients who were hospitalized from 2020 to 2023 through the hospital system.Use SPSS 29.0 software to compare the differences in hospitalization expenses among different inpatient groups using non parametric tests,and analyze the influencing factors of total hospitalization expenses using multiple linear regression.Result:The factors influencing the direct medical and economic burden of aging include length of stay(t=54.948,P<0.001),age(t=12.911,P<0.001),and disease type(t=7.618,P<0.001).Conclusion:It is necessary to strengthen the supervision of cost composition,steadily promote the hierarchical diagnosis and treatment model,better utilize grassroots medical institutions,improve service conditions,medical service management,and medical resource utilization,reduce the burden on patients and the social economy,and continue to improve the basic medical insurance system,exploring the establishment of payment methods based on different types of diseases.