兰州市肺结核患者住院费用及影响因素分析  

Study on Hospital Expenditure and Its Influence Factors of Tuberculosis Patients in Lanzhou

作　　者：郁娟[1] 韩芸倩 潘佳雪 张旭[1] 季韶荣 聂丹[1] 吴艳倩[1] 韩雪梅[1] 

机构地区：[1]兰州大学公共卫生学院,兰州730000 [2]孝感市中心医院,湖北孝感432000

出　　处：《中国初级卫生保健》2017年第1期17-20,共4页Chinese Primary Health Care

基　　金：2015年兰州市科技计划项目(2015-2-52);2015年甘肃省自然科学基金项目(1506RJZA229)

摘　　要：目的了解2014年兰州市医院肺结核患者的住院费用构成情况及影响因素,为有效控制医疗费用提供依据和参考。方法从甘肃省卫生计生统计信息网络直报系统中抽取2014年所有纳入医院的出院病人信息统计表,选取首次因活动性肺结核住院患者的有效病历信息共计710例,运用描述性分析、秩和检验和多元逐步线性回归分析方法对肺结核患者住院费用的影响因素进行分析。结果肺结核患者的平均住院费用为11 462.45元,中位数为7 047.50元,肺结核患者的住院费用构成中,前三位分别是药品费(32.58%)、综合医疗服务费(27.06%)和诊断类费用(21.18%)。影响肺结核患者住院费用的主要因素为药费、住院天数、手术情况、出入院诊断符合率、医院等级和入院病情。结论完善国家基本药物制度,引导医务人员合理用药,有效缩短患者住院天数,提高肺结核实验室诊断技术,加快推进分级诊疗制度,是有效控制住院费用的关键。OBJECTIVE To understand the structure of Lanzhou＇ s hospitalization expenses and its influencing factors of tuberculosis pa- tients in 2014, to provide reference and evidence for controlling the medical expense effectively. METHODS By extracting all informa- tion of patients discharged hospital statistics from in 2014 which were included in Gansu Health and Family Planning Statistical Infor- mation and Reporting System, selecting 710 patients with active tuberculosis and first hospitalization. The influent factors of hospital- ization expense were analyzed by descriptive analysis, Mann-Whitney U/Kruskal-Wallis H test and multinomial linear regression. RESULTS The mean of medical expenses of tuberculosis patients were 11 462.45 yuan, the median were 7 047.50 yuan. medicine fee（32.58%）, comprehensive medical services（27.06%） and diagnostic category costs（21.18%） were the top 3 in hospitalized tuberculo- sis patients cost structure. The major influencing factors were medicine fee, days of hospitalization, surgery, diagnosis coincidence rate, grade of hospitals and admission illness. CONCLUSION Improving the national essential drug system, guiding the patient ratio- nal using drug, extent, shortening the length of hospitalization, improving tuberculosis laboratory diagnostic techniques, accelerating medical classification system were the keys to control the hospitalization expense effectively.

关 键 词：肺结核 住院费用 影响因素 单因素分析 多元逐步线性回归分析 

分 类 号：R197[医药卫生—卫生事业管理]