某三级综合医院前五位罕见病住院费用影响因素分析  

An analysis of influencing factors on hospitalization expenses of the top five rare diseases in a tertiary general hospital

作　　者：张文[1] 马悦 李倩[1] 常征 李汶嘉 闫晓婷[1] ZHANG Wen;MA Yue;LI Qian;CHANG Zheng;LI Wenjia;YAN Xiaoting(First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院,陕西西安710061 [2]铜川市人民医院,陕西铜川727000

出　　处：《现代医院》2023年第4期585-588,595,共5页Modern Hospitals

基　　金：陕西省自然科学基金青年项目(2022JQ-750)。

摘　　要：目的分析陕西省某三甲医院2014—2021年前五位罕见病住院费用影响因素,为开展罕见病患者疾病经济负担研究提供研究基础。方法基于某三甲医院前五位罕见病患者病案首页数据,分析不同罕见病住院费用及构成,采用单因素分析和多因素分析方法对五种罕见病进行住院费用影响因素分析。结果五种罕见病次均费用中位数及标准差均有一定差异,药品费及诊断费为各罕见病住院费用的主要部分,占比均在70%左右。年龄、医保类型、入院途径、合并症及并发症种类、住院天数、是否手术六个因素罕见病患者住院费用有一定影响,其中住院天数、合并症及并发症种类及是否手术对各罕见病住院费用的影响较大。结论罕见病疾病经济负担需要引起关注,规范诊疗,减少不必要的检查检验,完善用药保障,对降低罕见病住院费用有一定的推动作用。Objective To analyze the influencing factors of hospitalization expenses of the top five rare diseases in a tertiary hospital in Shaanxi Province from 2014 to 2021,so as to provide a research basis for carrying out research on the economic burden of rare diseases.Methods To analyze the hospitalization expenses and composition of different rare diseases,and use single factor analysis and multi factor analysis to analyze the influencing factors of hospitalization expenses for five rare diseases,based on the first page data of the top five rare diseases in a tertiary hospital.Results The median and standard deviation of the average cost of the five rare diseases are different.Drug expenses and diagnosis expenses are the main part of hospitalization expenses for rare diseases,and the proportion is about 70%.The six factors of age,type of medical insurance,way of admission,types of comorbidities and complications,length of stay in hospital and whether to operate or not have a certain impact on the hospitalization expenses of rare diseases.The length of hospitalization,the types of comorbidities and complications,and whether to operate or not have a greater impact on the hospitalization costs of rare diseases.Conclusion The economic burden of rare diseases needs attention.Standardizing diagnosis and treatment,reducing unnecessary inspection and testing,and improving drug security have a certain role in promoting the reduction of hospitalization costs for rare diseases.

关 键 词：罕见病 住院费用 影响因素 

分 类 号：R197.323[医药卫生—卫生事业管理] R181.2[医药卫生—公共卫生与预防医学]