慢性阻塞性肺疾病患者住院费用及影响因素的通径分析  

Path Analysis of Hospitalization Expenses and Influencing Factors of Patients with COPD

作　　者：马春芳[1] 杨晓花 李月 汤榕[1] MA Chun-Fang;YANG Xiao-Hua;LI Yue;TANG Rong(School of Humanities and Management,Ningxia Medical University,Yinchuan 750000,China)

机构地区：[1]宁夏医科大学人文与管理学院,银川750000

出　　处：《中国药物经济学》2023年第12期21-25,30,共6页China Journal of Pharmaceutical Economics

基　　金：宁夏自然科学基金项目(2022AAC03212)。

摘　　要：目的 了解宁夏回族自治区某三甲医院慢性阻塞性肺疾病(COPD)患者住院费用及其影响因素,为减缓住院费用增长,减轻患者、社会医疗负担提供参考依据。方法 收集宁夏回族自治区某三甲综合医院2015年1月至2020年12月COPD患者的病案首页信息,运用描述性分析和多元线性回归拟合通径分析,研究COPD患者住院费用基本情况和影响因素。结果 共纳入4 035例COPD患者,平均住院费用17 627.32元,平均住院天数11.93 d。住院总费用主要由药品费、诊断费和耗材费构成。随着年份增长住院费用总体呈下降趋势。通径分析结果显示影响住院费用的直接因素主要有门诊、是否手术、年份、区内、郊县、转入、性别、其他医疗保险、全自费、3级手术、4级手术以及住院天数;通过住院天数间接影响住院费用的因素主要有门诊、是否手术、年份、区内、3级手术、4级手术、其他医疗保险和全自费。结论 宁夏回族自治区COPD患者住院费用负担较重,住院天数是住院费用最直接的影响因素,医院应加强临床路径管理,完善转诊和手术制度,减少不必要的住院天数,从而控制医疗费用和减轻患者负担。Objective To understand the hospitalization expenses of patients with chronic obstructive pulmonary disease(COPD)in a third-class hospital in Ningxia and its influencing factors,so as to provide reference for slowing down the increase of hospitalization expenses and reducing the medical expenses of patients and society.Methods Collect the first page information of COPD patients from January 2015 to December 2020 in a Class III general hospital in Ningxia,and use descriptive analysis and multiple linear regression fitting path analysis to study the basic situation and influencing factors of hospitalization expenses of COPD patients.Results A total of 4035 patients with COPD were included.The average hospitalization cost was 17627.32 yuan and the average length of stay was 11.93 days.The total cost of hospitalization is mainly composed of drugs,diagnosis and consumables.With the growth of the year,the total hospitalization expenses decreased.The results of path analysis showed that the main direct factors affecting the hospitalization expenses were outpatient service,surgery or not,year,district,suburb,transfer,gender,other medical insurance,full self-financing,third-level surgery,fourth-level surgery and hospitalization days;The main factors that indirectly affect the hospitalization expenses through the length of stay are outpatient service,whether or not to operate,year,district,third-level operation,fourth-level operation,other medical insurance and full self-financing.Conclusion The burden of hospitalization expenses of patients with COPD in Ningxia is heavy,and the length of stay is the most direct influencing factor of hospitalization expenses.Hospitals should strengthen the management of clinical pathway,improve the system of referral and surgery,and reduce unnecessary length of stay,so as to control medical expenses and reduce the burden of patients.

关 键 词：慢性阻塞性肺疾病 住院费用 影响因素 通径分析 

分 类 号：R563.3[医药卫生—呼吸系统] R956[医药卫生—内科学]