1563名股骨粗隆骨折患者费用结构变动分析  

Analysis on the Cost Structure Changes in 1563 Patients with Femoral Trochanteric Fractures

作　　者：杜惠丽[1] 左伟 梁泽峰[1] Du Huili;Zuo Wei;Liang Zefeng(The Second Hospital of Shanxi Medical University,Taiyuan 030001,Shanxi Province,China;不详)

机构地区：[1]山西医科大学第二医院,山西省太原市030001

出　　处：《中国病案》2024年第6期64-68,共5页Chinese Medical Record

基　　金：山西省科技战略研究专项(202204031401147);山西省社会经济统计科研课题(KYTJ[2022]010)。

摘　　要：目的 分析山西省四所三级综合医院股骨粗隆间骨折患者住院费用的结构变动度,为提升医院管理效率,优化医疗费用结构提供对策建议。方法 选取山西省4所三甲综合医院2019年1月1日-2021年12月31日期间出院的符合入排标准的1563名股骨粗隆间骨折患者的住院病案首页资料,运用结构变动度、结构变动值、结构变动贡献率等指标分析其住院费用结构的变化情况。结果 1563名股骨粗隆间骨折患者男女性别比1:1.41,年龄中位数80岁,手术患者1476名,合并其他疾病1322名。2021年合并其他疾病的股骨粗隆间骨折患者例均费用41 473元高于不合并疾病37 247元,差异具有统计学意义,P<0.05。2019-2021年,合并其他疾病的股骨粗隆间骨折患者例均费用增长52.40%,总结构变动度10.16%,治疗费、耗材费、药品费的结构变动贡献率分别为36.70%、31.94%、12.40%,是例均费用结构变化的主要项目。不合并其他疾病的股骨粗隆间骨折患者例均费用增长2.41%,总结构变动度6.46%,治疗费、药品费、耗材费的结构变动贡献率分别为39.29%、20.27%、19.80%,是例均费用结构变化的主要项目。结论 近3年股骨粗隆骨折患者治疗费、药品费影响医疗费用大,医疗费用结构仍需进一步优化,合并其他疾病患者的费用需进一步控制。Objectives To analyze the structural changes in hospitalization costs for patients with femoral intertrochanteric fractures in four tertiary comprehensive hospitals in Shanxi Province,and provide countermeasures and suggestions for improving hospital management efficiency and optimizing medical cost structure.Methods To select the front page’data of 1563 patients with femoral intertrochanteric fractures who met the inclusion criteria and were discharged from four tertiary comprehensive hospitals in Shanxi Province from January 1st,2019 to December 31st,2021,and analyze the changes in their hospitalization cost structure using indicators such as structure variation value,structure variation degree and contribution rate of structure variation.Results 1563 patients with intertrochanteric fracture of the femur had a gender ratio of 1:1.41,with a median age of 80 years.1476 patients underwent surgery,and 1322 patients had other complications.In 2021,the average cost of patients with intertrochanteric fractures of the femur combined with other diseases was 41473 yuan,which was higher than 37247 yuan(P<0.05).From 2019 to 2021,the average cost of patients with intertrochanteric fractures of the femur combined with other diseases increased by 52.40%,with a summarized degree of structural change of 10.16%.The contribution rates of treatment costs,consumables costs,and drug costs to the structural change were 36.70%,31.94%,and 12.40%,respectively,making them the main items in the average cost structure change.The average cost of patients with femoral intertrochanteric fractures who do not merge with other diseases increased by 2.41%,with a total structural change of 6.46%.The contribution rates of structural changes in treatment costs,drug costs,and consumables costs were 39.29%,20.27%,and 19.80%,respectively,which were the main changes in the average cost structure.Conclusions In recent 3 years,the treatment cost and drug cost of patients with trochanteric fracture of femur greatly affected the medical cost,the medical c

关 键 词：结构变动度 股骨粗隆骨折 住院费用 

分 类 号：R683[医药卫生—骨科学]