参加城镇职工医疗保险的缺血性脑梗死患者住院费用影响因素研究  

Research on the influence factor of hospitalization expenses of patients with ischemic cerebral infarction in urban employee medical insurance

作　　者：程沛然[1] 廖祖达 陈澍[1] 藤晓梅 邵建华[1] 

机构地区：[1]复旦大学附属华山医院,上海200040

出　　处：《卫生软科学》2018年第2期46-50,共5页Soft Science of Health

基　　金：上海市卫生和计划生育委员会科研课题:精细化DRGS在缺血性脑梗死医保支付管理中的运用(201540325)

摘　　要：[目的]对缺血性脑梗死患者的住院医疗费用的影响因素进行探索。[方法]采集了2014-2015年上海市10家三级甲等医院享有城镇职工医疗保险的出院病例且病案首页中第一诊断为缺血性脑梗死(ICD-10诊断编码为I63)的病史资料进行回顾性分析。[结果]药品费是总费用的最主要构成部分,占缺血性脑梗死费用构成的60.27%。[结论]药品费是总费用的主要构成,药费比、伴随疾病、治疗费比、年龄、检查费比、影像费比和入院情况是住院医疗费用的主要影响因素。建议关注促进合理用药、建立科学有效医疗质量管理新模式,同时推广高风险年龄段人群脑梗死筛查预防工作,以降低城镇职工医疗保险参保者用于缺血性脑梗死的住院费用。Abstract ： Objective To explore the influencing factors of hospitalization expenses in patients with ischemic cerebral infarction. Methotis Collected patients with urban employee medical insurance from 10 top hospitals in Shanghai from 2014 to 2015, whose first diagnosis were ischemic cerebral infarction （ ICD - 10 encoding for I63） , and retrospectively analyzed their medical history data. Results Drug fee was the main component of tolal cost, accounted for 60. 27%. Conclusions The drug fee proportion, associated disease, treatment fee proportion, age, examination fee proportion, imaging fee proportion and the admission condition are main influencing factors of hospitalization expenses. We should put more emphasis on promotion of rational drug use, establishing new management model and screening people in high - risk ages for prevention to reduce hospitalization expense.

关 键 词：缺血性脑梗死 住院医疗费用 影响因素 城镇职工 

分 类 号：R197.322[医药卫生—卫生事业管理]