乙型肝炎后肝硬化失代偿期患者次均住院费用新灰色关联与结构变动分析  

New gray correlation and structural variation degree analysis of average hospitalization costs of patients with hepatitis B cirrhosis at decompensated stage

作　　者：邓淑敏 师雯琦 李莉莉[2] 陈晓霞[1] 刘子锋[1] 陈静静 Deng Shumin;Shi Wenqi;Li Lili;Chen Xiaoxia;Liu Zifeng;Chen Jingjing(Big Data and Artificial Intelligence Center,The Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510000,China;Department of Infectious Diseases,The Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510000,China)

机构地区：[1]中山大学附属第三医院大数据人工智能中心,广东广州510000 [2]中山大学附属第三医院感染科,广东广州510000

出　　处：《中国医院统计》2024年第2期113-117,共5页Chinese Journal of Hospital Statistics

摘　　要：目的了解某院乙型肝炎后肝硬化失代偿期患者次均住院费用内部构成及变化,为降低患者医疗负担、优化住院费用结构及控制医药费用增长提供参考。方法选取广东省某三级甲等医院2018年1月至2023年8月期间7459例次乙型肝炎后肝硬化失代偿期患者的住院费用明细,运用新灰色关联与结构变动分析法对患者各细项费用的关联度、变动度及贡献率等指标进行统计分析。结果2018—2021年该院乙型肝炎后肝硬化失代偿期患者次均住院费用逐年增长,年均增长7.01%;2022年和2023年出现下降,较上年分别下降7.64%和8.04%。次均住院费用构成比前4位是药品费、诊断费、耗材费、治疗费。次均住院费用关联度最大的是药品费(0.915),其次是诊断费(0.909)和耗材费(0.770)。结构贡献率前3位是药品费(43.27%)、诊断费(19.12%)、耗材费(17.91%),3者累计结构变动贡献率超过80%。结论药品费、诊断费和耗材费是影响住院费用的主要因素,是降低患者住院费用的重点;需进一步调整优化住院费用结构,体现医务人员劳动技术价值,降低患者医疗费用负担。Objective To understand the average hospitalization cost structure of patients with hepatitis B cirrhosis at decompensated stage from January,2018 to August,2023,so as to provide a reference for reducing the medical burden of patients,optimizing the hospitalization cost structure and controlling the growth of medical costs.Methods The medical costs of 7459 patients with hepatitis B cirrhosis at decompensated stage in a tertiary hospital in Guangdong Province from a January,2018 to August,2023 were selected.Grey correlation and structural variation degree analysis method were used to analyze the correlation degree,variation degree and contribution rate of each item cost of patients.Results The average hospitalization cost of patients with decompensated post-hepatitis B cirrhosis increased year by year from 2018 to 2021,with an average annual growth of 7.01%,and then decreased in 2022 and 2023,with a decline rate of 7.64%and 8.04%,respectively.The top four costs were the drug cost,the diagnosis cost,the consumables cost,and the treatment cost.The drug cost(0.915),the diagnosis cost(0.909)and the consumables cost(0.770)had the highest correlation coefficient.The top three items with the highest structural contribution rate were drug cost(43.27%),diagnostic cost(19.12%),and consumables cost(17.91%),and the cumulative structural change contribution rate of the three was over 80%.Conclusion The drug cost,diagnostic cost and consumables cost were the main factors affecting hospitalization costs,and were the key points to reduce the hospitalization cost of patients.It is necessary to further adjust and optimize the structure of hospitalization costs,reflect the labor and technology value of medical staff,and reduce the burden of patients′medical expenses.

关 键 词：住院费用 新灰色关联 结构变动度 乙型肝炎后肝硬化失代偿期 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学] R197.323