基层医疗机构住院量和住院费的季节性与变化趋势研究  

Seasonal Trends of Inpatient Number and Hospital Expenses in Primary Health Care Facilities

作　　者：李长风[1] 柯思思[1] 刘新会[1] 严亚琼[1] 李芳[1] 王亮[1] 

机构地区：[1]武汉市疾病预防控制中心,湖北武汉430015

出　　处：《中国社会医学杂志》2017年第6期608-611,共4页Chinese Journal of Social Medicine

基　　金：武汉市卫生计生委医疗卫生科研项目(WG14C07)

摘　　要：目的探讨基层医疗机构住院量与人均住院费用的季节性与年度变化规律,并利用ARIMA季节模型预测未来趋势。方法用SAS软件基于2011—2014年基层医疗机构住院量与住院费用建立时间序列模型,分析季节变化与年度变化趋势,并利用模型预测2014年10—12月的住院量和住院费用。结果机构月住院量逐年增长,并有冬、春两季波峰,春节出现谷底的季节性变化。人均住院费用有缓慢上涨趋势,4年内从1 280元增至1 884元,年均增幅为11.8%。月住院量模型为ARIMA(0,1,1)×(0,1,1)_(12),AIC=564.463 5,SBC=568.667 1,人均住院费用模型为ARIMA(2,1,2)×(0,1,0)_(12),AIC=382.107 5,SBC=387.576 7。3个月的住院量预测值的平均相对误差为9.03%,人均住院费预测值的平均相对误差为0.31%。结论 ARIMA季节模型能较好预测短期趋势,基层医疗机构住院量逐年增长并存在季节性变化,住院费用较为平稳但仍有缓慢上涨趋势,建议合理调配区域卫生资源,提高基层主要住院病种诊疗防治技术。Objectives To analyze the seasonal trends of the monthly inpatient number and hospital expenses in primary health care facilities,and predict the future trends with seasonal ARIMA model.Methods We establish the time series models by the SAS system,based on the inpatient number and hospital costs among primary health care facilities from 2011 to 2014,and analyze seasonal and annual changes,forecast the next three months＇ inpatient number and hospital expenses respectively.Results The monthly inpatient number increased year by year with two peak in winter and spring,one valley in the Spring Festival.Per capita hospital expenses had slow rise trend from 1 280 in March 2011 to Nov 2014,with 11.8%,annual growth rate.The monthly inpatient number model was ARIMA（0,1,1）×（0,1,1）12,AIC=564.463 5,SBC=568.667 1,Per capita expenses model was ARIMA（2,1,2）×（0,1,0）12,AIC=382.107 5,SBC=387.576 7.The observation values of monthly inpatient number and hospital costs were all in the 95%confidence internals,the Mean Relative Error of monthly inpatient number was 9.03%,of which the hospital costs model was 0.31%.Conclusions ARIMA seasonal models can be well used to predict the monthly inpatient number and hospital costs in short periods.The monthly inpatient number increases year by year with season＇s fluctuations.Per capital hospitalization expense has a slow rise and stable trend.It is necessary to enhance allocation of regional health resource and improve common diseases diagnosis and treatment technology in primary health care facilities.

关 键 词：住院量 住院费用 季节性 趋势 

分 类 号：R197.32[医药卫生—卫生事业管理]