基于结构方程模型的脑卒中患者住院费用影响因素分析  

Analysis of factors influencing hospitalization cost of stroke patients based on structural equation model

作　　者：吴玲红 丁丽 丁仁声[1] Wu Linghong;Ding Li;Ding Rensheng(The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, China;Medical Education Department, Sichuan Provincial People′s Hospital (East Hospital), Chengdu 610101, China)

机构地区：[1]广西医科大学第四附属医院统计科,广西柳州545005 [2]四川省人民医院(东院)医教科,四川成都610101

出　　处：《中国医院统计》2021年第2期143-148,共6页Chinese Journal of Hospital Statistics

摘　　要：目的分析脑卒中患者住院费用的影响因素,为合理控制和降低住院费用提供有针对性、可操作性的措施。方法收集某院2019年住院病案数据库中疾病主要诊断为脑卒中(诊断编码为I60-I64)的患者2343例,采用单因素分析和路径分析脑卒中患者住院费用的影响因素。结果脑卒中患者平均住院费用为21532元。其中,药品费用及检查费用占比较大;患者的住院天数、药品费用和总费用在不同年龄、医疗付费方式、服务区域半径、入院情况、有无高血压、是否手术及其他疾病诊断个数方面差异有统计学意义(P<0.05);住院费用路径分析显示药品费(总效应β=0.73,P<0.05)为住院费用的主要影响因素,其次为住院天数(β=0.53,P<0.05),是否手术、入院情况、其他疾病诊断个数、服务区域半径、年龄、有无高血压和医疗付费方式也对住院费用产生影响,β分别为-0.52、0.14、0.12、0.06、-0.06、-0.04和-0.03(P<0.05)。结论药品费、住院天数、是否手术、入院情况、其他疾病诊断个数、服务区域半径、年龄、有无高血压和医疗付费方式影响脑卒中患者的住院费用,可通过控制药品费用、缩短住院天数等综合措施,控制和降低脑卒中患者的住院费用。Objective To describe the hospitalization expenses of stroke patients and analyze the influencing factors,so as to provide targeted and operable measures for reasonable control and reduction of hospitalization expenses.Methods Totally 2343 inpatients with stroke(I60-I64)in the inpatient medical record database of a hospital in 2019 were collected,and univariate analysis and path analysis were used to analyze the influencing factors of hospitalization expenses of stroke patients.Results The average hospitalization cost of stroke patients was 21531 yuan.Among them,drug fees and inspection fees accounted for a relatively large proportion.There were statistically significant differences in the number of hospitalization days,drug costs,and total costs of patients with different ages,medical payment methods,service area radius,hospital admissions,presence or absence of hypertension,surgery,and other diagnoses(P<0.05).The SEM results showed that the drug cost(β=0.73,P<0.05)was the most important influencing factor of hospitalization expenses,followed by the length of hospitalization(β=0.53,P<0.05).The presence or absence of surgery,admission status,number of other diagnoses,service area radius,age,presence or absence of hypertension,and medical payment methods also had an impact on the cost of hospitalization,with-0.52,0.14,0.12,0.06,-0.06,-0.04,and-0.03(P<0.05).Conclusion Drug fees,length of stay,surgery,admission status,number of other diagnoses,radius of service area,age,hypertension,and medical payment methods have a significant effect on the total hospitalization cost.Drug cost is the most important factor.The cost of hospitalization of stroke patients can be controlled and reduced by controlling the cost of drugs and shortening the length of hospitalization.

关 键 词：脑卒中 住院费用 影响因素 路径分析 

分 类 号：R195.4[医药卫生—卫生统计学]