兰州市2型糖尿病患者住院费用影响因素的通径分析  

Path Analysis of the Factors Influencing Hospitalization Expenses of Type 2 Diabetes Mellitus Patients in Lanzhou

作　　者：张旭[1] 郁娟[1] 潘佳雪 常高峰 韩雪梅[1] ZHANG Xu;YU Juan;HAN Xuemei(School of Public Health,Lanzhou University,Lanzhou,730000,China)

机构地区：[1]兰州大学公共卫生学院,甘肃兰州730000 [2]宁夏医科大学公共卫生与管理学院,宁夏银川750000

出　　处：《中国社会医学杂志》2018年第6期634-637,共4页Chinese Journal of Social Medicine

基　　金：甘肃省自然科学基金项目(1506RJZA229)

摘　　要：目的分析影响2型糖尿病患者住院费用的相关因素,为控制住院费用的增长提供参考。方法运用描述性统计和通径分析方法对患者住院费用的影响因素进行分析。结果通径分析显示,医院级别、职业、付费方式、是否手术、有无并发症,既对住院费用产生直接影响,也可通过住院天数间接影响住院费用,性别、入院病情只对住院费用产生直接影响,年龄、并发症数目仅通过住院天数对住院费用产生间接影响。医院级别对住院费用影响的总效应最大,其系数分别为0.524,0.042,总效应系数为0.566;其次分别为住院天数,总效应系数为0.285;是否手术、有无并发症,总效应系数分别为0.174,0.114。结论在保证医疗质量的前提下,减少无效住院天数、合理分流患者到不同级别医院就诊、加强医保监管的同时扩大覆盖人群,并做好二级预防和健康教育,可有效控制患者住院费用增长。Objective To analyze the factors and structures influencing hospitalization expenses of type 2 diabetes mellitus patients in Lanzhou,aiming at providing a basis to control the medical expenses to a more reasonable level so as to reduce patients’ economic burden.Methods Descriptive statistical analysis and pathway analysis were applied to exploring influencing factors of hospitalization costs.Results Pathway analysis showed that hospital class was the most important influencing factor of hospitalization expenses,the coefficient were 0.524 and 0.042 and the overall coefficient was 0.566;the next was hospital stay with the overall coefficient 0.285.Other factors included complication,patient’s occupation,gender,payment methods,age and surgery or not.Conclusion Strategies including reducing drug costs,shortening hospital stay,grading clinics,carrying out health education and secondary prevention may be effective to low the current unaffordable high hospitalization expenses.

关 键 词：2型糖尿病 住院费用 影响因素 通径分析 

分 类 号：R197.3[医药卫生—卫生事业管理]