呼吸系统感染患者住院费用灰色关联及影响因素分析  

Analysis of gray correlation and influencing factors of hospitalization expenses for patients with respiratory infection

作　　者：高姣姣 宋玉磊[1] 柏亚妹[1] 王蒙蒙 徐桂华[1] 张薛晴 王野 臧琼琼 GAO Jiaojiao;SONG Yulei;BAI Yamei;WANG Mengmeng;XU Guihua;ZHANG Xueqing;WANG Ye;ZANG Qiongqiong(School of Nursing,Nanjing University of Chinese Medicine,Nanjing,Jiangsu Province,210023,PRC)

机构地区：[1]南京中医药大学护理学院,210023江苏省南京市

出　　处：《中国医院》2024年第2期20-23,共4页Chinese Hospitals

基　　金：国家自然科学基金青年项目(72004102);教育部人文社科青年基金项目(19YJCZH139);江苏省研究生科研与实践创新计划(SJCX23_0723)。

摘　　要：目的:分析呼吸系统感染患者住院费用的构成及内、外部影响因素,为公立医院实施DRG付费改革、控制医疗费用、提高医疗服务质量提供参考。方法:收集2021年江苏省某三甲医院呼吸内科呼吸系统感染住院患者579例,提取患者病案基本信息和各项住院费用明细,采用单因素分析、灰色关联分析、多元逐步线性回归分析对呼吸系统感染患者住院费用的内、外部影响因素进行分析。结果:与呼吸系统感染患者住院费用关联度最高,关联序列排前三位的费用:西药费(0.979)、一般医疗服务费(0.969)和实验室诊断费(0.938)。住院天数、年龄、合并症数量和吸烟史对呼吸系统感染患者的住院费用有显著影响。结论:建议定期审查医院各项费用和成本效益,完善临床诊疗规范,进一步加强控制西药费用,减少不必要的医疗服务和实验室检查;同时尝试建立早期出院计划以减少住院天数,积极做好健康宣传,提高民众健康素养。Objective:Analyze the composition of hospitalization expenses for patients with respiratory infections and internal and external influencing factors to provide reference for public hospitals to implement DRG payment reform,control medical expenses,and improve the quality of medical services.Methods:Collected 579 cases of hospitalized patients with respiratory system infections in the Department of Respiratory Medicine of a Grade III Level A hospital in Jiangsu Province in 2021,extracted the basic information of the patient's medical records and details of various hospitalization expenses and used single factor analysis,gray correlation analysis,and multiple stepwise linear regression analysis to analyze the hospitalization of patients with respiratory system infections.Analyze internal and external factors affecting costs.Results:It has the highest correlation with hospitalization expenses for patients with respiratory infections,and the top three expenses in the correlation sequence are:western medicine fees(0.979),general medical service fees(0.969),and laboratory diagnosis fees(0.938).Length of hospitalization,age,number of comorbidities,and smoking history significantly affect hospitalization costs for patients with respiratory infections.Conclusion:It is recommended that hospital fees and cost-effectiveness be regularly reviewed,that clinical diagnostic and treatment protocols be improved,that control of the cost of western medicines be further strengthened,and that unnecessary medical services and laboratory tests be reduced;at the same time,attempts should be made to establish an early discharge program to reduce the number of days of hospitalization,and that health promotion be actively pursued in order to improve the population's health literacy.

关 键 词：DRG 呼吸系统感染 住院费用 灰色关联分析 多元逐步回归分析 

分 类 号：R197.3[医药卫生—卫生事业管理]