不同病种医改前后住院费用的初步分析  

Analysis of hospital costs of different diseases before and after health reform preliminary

作　　者：刘建超[1] 赛晓勇[1] 刘建寨[1] 李林[1] 

机构地区：[1]解放军总医院,北京100853

出　　处：《中国医药导报》2013年第21期132-134,137,共4页China Medical Herald

基　　金：国家医药卫生科学数据共享网课题(编号2005DKA32403)

摘　　要：目的比较医改前后不同病种住院费用的总费用和次均费用以及不同费用类别的前后变化,为医改对费别与单病种费用影响提供参考依据。方法采用整群抽样的方法分别对某大型综合医院2008年(医改前)和2011年(医改后)181 316份病例的单病种费用及其前后变化进行初步分析。结果将住院患者费用按照不同类别分为西药、中药、化验、检查、治疗、手术、麻醉、血费、材料、床位、护理、膳食和其他13类,医改前后除血费外所有费用总费用增加,而次均费用有6种增加,幅度最大为中药61.36%,7种减少,幅度最大为血费36.79%。按不同病种分,有24种疾病次均费用增加,幅度最大为脑梗死53.67%,26种疾病次均费用减少,幅度最大为内分泌腺其他和未特指的良性肿瘤24.65%。结论医改对该医院费别平均费用均有影响,对单病种次均费用影响较大,卫生部门应根据不同的病种进一步扩大医改成果。Objective To campare the changes before and after the reform of different disease hospitalization costs and the average expense and different categories of cost, to provide the reference for the effects of health reform on medical treatment and the cost of single disease. Methods Using the method of cluster sampling to preliminary analysis of the 181 316 hospitalized expense and its changes in 2008 （before the health reform） and 2011 （after the reform） in a general hospital. Results The inpatient expenses were divided into western medicine, Chinese medicine, laboratory test, exami- nation, treatment, operation, anesthesia, blood fee, materials, bed, nursing, diet and other 13 category health care ac- cording to the difference of category, after health reform all costs total cost were increases except blood costs, while the time cost were increased in 6 species, the amplitude of the maximum for traditional Chinese medicine was 61.36%, and decreased in 7 species, the maximum amplitude for blood fee was 36.79%. According to different diseases, there were 24 kinds of diseases cost increased, the maximum rate of cerebral infarction was 53.67%, 26 kinds of diseases cost were reduction, the maximum rate of endocrine glands of other and unspecified was 24.65% benign tumors. Con- clusion Health reform have effects on the average costs of the cost category in this hospital, medical treatment cost of single disease is impacted the most, the health departments should expand health reform achievement based on different diseases.

关 键 词：医院管理 住院费用 医保费别 医疗改革 

分 类 号：R197.3[医药卫生—卫生事业管理]