城乡医保居民住院医疗费用比较及其影响因素研究  

Comparison of the hospitalization costs between medicare-covered urban and rural residents and analysis of the relevant influencing factors

作　　者：计阿丹[1] 张龙 孙星 马晨东[4] 肖倩[1] 赵冬梅[1] 肖永红[1] 

机构地区：[1]河北联合大学公共卫生学院,河北唐山063000 [2]河北省滦县基本医疗保险中心,河北唐山063700 [3]河北省滦县卫生局,河北唐山063700 [4]河北体育学院,河北石家庄500041

出　　处：《现代预防医学》2014年第8期1408-1411,共4页Modern Preventive Medicine

基　　金：河北省社会科学基金项目(HB13SH027)

摘　　要：目的分析比较城镇参保居民和农村参合居民住院医疗费用的差异,探讨其影响因素,为完善城乡居民医疗保障制度提供参考。方法选取某县2011年1月1日-2011年12月31日参保和参合居民住院患者,采用单因素分析和多元回归法分析住院费用的影响因素。结果参保患者平均住院费用(2 069.77元)显著高于参合患者平均住院费用(1 936.11元)(P<0.05),两种医保患者的住院费用构成中,排在前三位的均依次是药费、治疗费和检查费,其中参保患者的药费、手术费和特殊检查费高于参合患者(P<0.05)。城乡医保居民住院医疗费用的共同影响因素为年龄、住院日、有无手术、特殊检查和医院级别。结论控制药费的增长,有助于减轻居民的住院医疗费用支出;根据年龄特点,尽量地减少特殊仪器检查,严格掌握手术适应症,以减少住院日,从而降低住院费用。Objective The study was conducted to analyze and compare the differences in hospitalization costs between medicare-covered urban and rural residents and to explore the relevant influencing factors for the differences, so to provide references for the improvement of medical insurance policies for urban and rural residents. Methods Medicare-covered urban and rural residents of a county who were hospitalized between January 1 and December 31 of 2011 were selected, and the influencing factors for their hospitalization costs were analyzed by univariate analysis and multivariate regression. Results Average hospitalization cost of the urban residents （~2069.77） was significantly higher than that of the rural residents （~ 1936.11） （P〈0.05）. Prescription fee, treat- ment fee, and check-up fee ranked the highest among all the costs for a hospital stay of the two groups of patients; and prescription fee, surgery fee, and special check-up fee of the urban patients were higher than those of the rural patients （P〈0.05）. Common fac- tors affecting the hospitalization costs of the two groups included age of patient, length of hospital stay, need for a surgery, need for a special physical examination, and administrative level of the hospital. Conclusion Controlling the rise in prescription fees would he helpful in reducing the costs of hospitalization of the residents. The use of special equipments for physical examinations should be avoided in accordance with the characteristics of patients＇ age, and the indications for surgery should be strictly assessed to reduce the length of hospitalization, so to lower the costs of hospitalization.

关 键 词：城镇居民医疗保险 新型农村合作医疗 住院医疗费用 影响因素 多元回归分析 

分 类 号：R181.2[医药卫生—流行病学]