单病种付费制度下影响患者住院费用的关键因素--以广东省中山市黄圃人民医院为例  

Key Factors Affecting the Hospitalization Expenses Under the Single Disease Payment System-Taken Zhongshan Huangpu People's Hospital in Guangdong Porvince as the Example

作　　者：陆石娣 Lu Shidi(Zhongshan Huangpu People's Hospital,ZhongshanGuangdong 528429,China)

机构地区：[1]中山市黄圃人民医院,广东中山528429

出　　处：《医疗装备》2022年第3期83-86,共4页Medical Equipment

摘　　要：目的分析单病种付费制度下影响广东省中山市黄圃人民医院患者住院费用的关键因素,为采取合理有效的控制措施降低住院费用提供参考。方法选取广东省中山市黄圃人民医院2019年1月1日至12月31日出院的单病种付费患者例数排名前5位的病种为研究对象,包括肺炎1507例、急性支气管炎819例、椎基底动脉综合征710例、慢性阻塞性肺疾病伴下呼吸道感染360例及支气管扩张255例。收集上述患者的临床资料,以住院天数、服务费、诊断费、治疗费、药费、耗材费、其他费用为主要考虑的因素,采用多因素逐步回归分析方法分析单病种付费制度中影响患者住院费用的关键因素。结果广东省中山市黄圃人民医院5个病种的单病种结算平均费用均低于医院平均费用;除急性支气管炎与椎基底动脉综合征外,医院其他3个病种的单病种结算平均费用均高于广东省二级医疗机构平均费用。诊断费、治疗费、药费均是影响上述5个病种单病种付费住院费用的关键因素;耗材费是影响除支气管扩张外,其他4个病种住院费用的关键因素,而服务费仅对支气管扩张有影响。医院5个病种的药占比均低于广东省二级医疗机构,差异有统计学意义(P<0.05)。在椎基底动脉综合征、慢性阻塞性肺疾病伴下呼吸道感染的临床诊治中,医院耗材占比高于广东省二级医疗机构,其他3个病种低于广东省二级医疗机构,差异有统计学意义(P<0.05)。除椎基底动脉综合征外,医院患者的平均住院天数均多于广东省二级医疗机构,差异有统计学意义(P<0.05)。结论诊断费、治疗费、药费是影响广东省中山市黄圃人民医院住院费用的关键因素,应合理减少收费项目,降低医疗成本损耗,提高医疗质量。Objective The key factors affecting the hospitalization expenses in Zhongshan Huangpu People's Hospital in Guangdong porvince under the single disease payment system were analyzed to provide references for taking reasonable and effective control measures to reduce the hospitalization expenses.Methods The top five diseases in the number of patients discharged from Zhongshan Huangpu People's Hospital in Guangdong province from January 1,2019 to December 31,2019 were selected as the research objects,including 1507 cases of pneumonia,819 cases of acute bronchitis,710 cases of vertebrobasilar syndrome,360 cases of chronic obstructive pulmonary disease with lower respiratory tract infection,and 255 cases of bronchiectasis.The clinical data of the above patients were collected and then taking length of stay,service fee,diagnosis fee,treatment fee,medicines fee,consumables fee and other costs as the main considered factors,the key factors affecting the hospital expenses were analyzed by multi-factor step-by-step regression analysis method.Results The average expenses of single disease payment for the five diseases in Zhongshan Huangpu People's Hospital in Guangdong porvince were all lower than the average expenses of the hospital;Except for acute bronchitis and vertebrobasilar syndrome,the average expenses of single disease payment for the other three diseases in the hospital were higher than the average expenses of secondary medical institutions in Guangdong province.The diagnosis fee,treatment fee,and medicines fee were the key factors that affect the single disease payment of hospitalization expenses of the above five diseases in the hospital.The consumables fee was the key factor that affects hospitalization expenses of the other four diseases except for bronchiectasis,while service fee only affected bronchiectasis.The proportions of medicines for the five diseases in the hospital were all lower than those of secondary medical institutions in Guangdong province,and the differences were statistically significant(P<0.0

关 键 词：单病种付费 住院费用 影响因素 

分 类 号：R197.39[医药卫生—卫生事业管理]