山东省某医院剖宫产住院费用变化及影响因素分析

Study on Changes and Influencing Factors of Cesarean Hospitalization Expense in a Hospital of Shandong

目的:分析山东省某三甲医院剖宫产住院分娩费用,探讨不同组别下费用差异及影响因素,为分娩费用支付标准的制定及支付方式的改革提供参考。方法:选择某三甲医院2010—2014年剖宫产住院分娩数据,采用SPSS 19.0进行数据整理、描述及多元线性回归分析。结果:高龄产妇费用高于低龄产妇;分娩费用随合并症/并发症严重程度的加深而上升;直切口手术费用高于横切口手术;费用影响因素包括住院天数、合并症/并发症严重程度、年龄和手术方式。结论:加强高龄产妇孕期保健;强化医院成本管理,缩短住院天数;积极探索单病种分组付费,确定剖宫产费用的不同支付标准。

Objective:To analyze hospitalization expense of cesarean delivery in a tertiary hospital of Shandong and discuss the cost differences and influencing factors by different groups,so as to provide references for the design of delivery expense payment standard and payment reform.Methods:With hospitalization data of cesarean delivery in a hospital between 2010 and 2014,SPSS19.0 was applied to sort,describe and analyze multiple linear regression.Results:The expense for elderly pregnancy was higher than young pregnancy;delivery cost increased with morbidities/complications severity increased;straight incision surgery cost more than transverse incision;the main factors affecting the cost included length of hospitalization, complications/complications severity,age and surgical approach.Conclusion:It needed to strengthen prenatal care for elderly pregnancy;intensify costing management so as to shorten hospitalization days;actively explore the implementation of single Diagnosis Related Groups payment to determine different payment standards of cesarean.