生育保险病种费用影响因素结构方程模型分析  

Structural equation models of influence factors on expenses of specific diseases in maternity insurance

作　　者：杨树东[1] 闵捷[2] 沈其君[3] 张晓[2] 王福华[4] 何建敏[1] 

机构地区：[1]东南大学经济管理学院,江苏南京210009 [2]东南大学公共卫生学院,江苏南京210009 [3]宁波大学医学院预防医学研究所,浙江宁波315211 [4]南京市医疗保险结算管理中心,江苏南京210017

出　　处：《第四军医大学学报》2008年第1期81-83,共3页Journal of the Fourth Military Medical University

基　　金：劳动与社会保障部生育保险医疗费用病种结算项目(劳社厅发[2004]14)

摘　　要：目的:研究生育保险病种费用影响因素,为生育保险按病种付费提供依据.方法:抽取南京市4家医院2002/2004生育保险参保人员病历首页以及财务结算帐单1525份,用结构方程模型(SEM)方法分析.结果:临床特征、医护质量和社会经济特征三个隐变量对住院费用的影响系数分别为0.9334,0.3194,0.2230,病种临床特征对住院费用影响最大.结论:结构方程模型分析生育保险病种住院费用影响因素收到很好的效果.AIM： To study the influencing factors on the expense of specific diseases in the maternity insurance and to give the evidence for payment system according to specific diseases. METHODS： The structural equation models were used to analyze the data case file and financial account of 1525 cases from 2002 to 2004 from 4 hospitals in Nanjing. RESULTS： The effect coefficients of the clinical characters, the quality of medical care and the social-economic character were 0. 9334, 0. 3194, 0. 2230, respectively. In the 3 latent variables, the effect coefficient of clinical character is most significant on the medical cost. CONCLUSION： The structural equation models have been established and can effectively analyze the influencing factors on the expenses of specific diseases in maternity insurance.

关 键 词：结构方程模型 生育保险 病种费用 影响因素 

分 类 号：R197.1[医药卫生—卫生事业管理]