参保心力衰竭患者住院费用及影响因素分析  

Hospitalization expense and its influencing factors in heart failure patients with medical insurance

作　　者：刘媛媛[1] 李长平[1] 崔壮[1] 柯慧[1] 宋春华[1] 朱宝[1] 马骏[1] 

机构地区：[1]天津医科大学公共卫生学院卫生统计学教研室,天津300070

出　　处：《中国公共卫生》2013年第3期313-315,共3页Chinese Journal of Public Health

基　　金：全国统计科学研究计划项目(2009LY048;2009LY011);2011年度教育部人文社会科学研究青年基金(11YJCZH080;11YJCZH022)

摘　　要：目的了解天津市参加城市居民基本医疗保险的心力衰竭患者住院费用构成及其影响因素,为合理控制住院费用提供参考依据。方法从天津市2004—2007年城市居民基本医疗保险数据库中随机抽取心力衰竭确诊患者307例,对其住院费用情况进行回顾性分析。结果天津市2004—2007年参保心力衰竭患者人均住院费用为9 266.61元,其中一级医院为3 517.34元,二级医院为5 890.92元,三级医院为10 313.73元;参保心力衰竭患者药品费、检查费、治疗费、手术费、床位费、医用材料费、成分输血费和其他费用分别为5 379.29、1 380.62、1 532.33、28.21、422.54、473.42、1.43和48.76元,分别占58.05%、14.90%、16.54%、0.30%、4.56%、5.11%、0.02%和0.53%;多元线性回归分析结果表明,医院级别越高、住院天数越多和手术治疗的心力衰竭患者住院费用越高;女性心力衰竭患者住院费用低。结论性别、医院级别、住院天数和手术治疗是天津市参保心力衰竭患者住院费用的主要影响因素。Objective To analyze hospitalization expense and its main influencing factors in heart failure patients with medical insurance and to provide references for controlling the excessive increase of medical expense. Methods Retrospective study was conducted based on a random sample of 307 hospitalized patients with medical insurance from January 2004 to December 2007 in Tianjin city. Results The mean of hospitalization cost was 9 266. 61 RMB Yuan per patient in Tianjin from 2004 to 2007. The mean of hospitalization cost was 3 517. 34 RMB Yuan per patient for first-grade hospital,5 890. 92 RMB Yuan per patient for second-grade hospital, and 10 313.73 RMB Yuan per patient for third-grade hospital,respectively. The item proportions of hospitalization cost of the patients were medicine （5 379.29 RMB Yuan, 58. 05% ） ,inspection （ 1 380. 62 RMB Yuan, 14. 90% ）, treatment （ 1 532. 33 RMB Yuan, 16. 54% ）, surgery （ 28.21 RMB Yuan,0. 30% ） ,beding（422. 54 RMB Yuan,4. 56% ） ,materials （473.42 RMB Yuan,5.11% ） ,blood component transfusion （ 1.43 RMB Yuan, 0.02% ）, and other costs （ 48.76 RMB Yuan, 0. 53 % ）. The results of multiple linear regression showed that the patients hospitalized in higher rank hospital, with longer duration of stay, and having surgery had more hospitalization expense than other patients and the female patients had less expense. Conclusion Gender,rank of hospital, duration of stay, and surgery are influencing factors of the hospitalization cost for heart failure patients with medical insurance in Tianjin city.

关 键 词：心力衰竭 参保患者 住院费用 影响因素 

分 类 号：R197.1[医药卫生—卫生事业管理]