新疆公立医院0-6岁道路交通伤害患儿住院费用分组研究  

Study on the Grouping of Hospitalization Expenses for 0-6 Years Old Children with Road Traffic Injuries in Public Hospitals in Xinjiang

作　　者：权晓雯 杨圆圆[2] 芦浩雅 霞依丹·阿不都色米 罗振 方娴[1] QUAN Xiaowen(School of Public Health,Xinjiang Medical University,Urumqi,Xinjiang,830011,China)

机构地区：[1]新疆医科大学公共卫生学院,新疆乌鲁木齐830011 [2]新疆医科大学第一附属医院医务管理科,新疆乌鲁木齐830011

出　　处：《医学与社会》2024年第10期138-144,共7页Medicine and Society

基　　金：新疆维吾尔自治区自然科学基金“新疆0-6岁儿童伤害特征及预测和疾病负担研究”,编号为2020D01C164。

摘　　要：目的:分析新疆公立医院0-6岁道路交通伤害患儿住院费用并构建费用分组方案,为科学选择费用控制组合、制定针对性费用控制措施提供参考。方法:收集2010-2021年新疆8所公立医院0-6岁道路交通伤害住院患儿病案首页数据,采用分位数回归模型筛选分类节点变量,将有影响作用的变量纳入CHAID决策树模型构建住院费用分组模型并计算各组费用标准。结果:共纳入0-6岁道路交通伤害住院患儿3017例,住院费用均值13726.59元。以是否手术、医院等级、居住地、入院状态、受伤部位等影响因素为分类节点构建8个分组病例组合,并制定相应住院费用标准,住院费用超出限额的病例共238例(7.89%)。其中,费用最低组住院费用均值2257.10元,费用上限为5167.90元;费用最高组住院费用均值22128.45元,费用上限为78405.33元。结论:新疆公立医院0-6岁道路交通伤害患儿住院费用较高,利用分位数回归和CHAID决策树模型构建道路交通伤害患儿住院费用分组较为合理,费用标准可为医院和医保机构制定政策提供参考。Objective:This paper analyzes the hospitalization expenses of 0-6 year old children with road traffic injuries in public hospitals in Xinjiang and constructs a cost grouping to provide a reference for scientifically selecting the optimal cost control combination and formulating targeted cost control measures.Methods:Retrospectively collect medical record data of road traffic injury hospitalizations for children aged 0-6 years from eight public hospitals in Xinjiang from 2010 to 2021.quantile regression model was used to screen the classification node variables,and influential variables were included in the CHAID decision tree to construct a hospitalization expense grouping model and calculate the standard expenses of each group.Results:A total of 3017 hospitalized children aged 0-6 years old with road traffic injuries were included in this study,with an average hospitalization expense of 13726.59 yuan.According to the influencing factors such as operation,hospital grade,place of residence,admission status,and injured site,eight groups of cases were constructed,and the corresponding hospitalization expense standards were formulated.There were 238 cases(7.89%)with hospitalization expenses exceeding the standard.Among them,the average hospitalization expense of the lowest cost group was 2257.10 yuan,and the upper limit of the expense was 5167.90 yuan.The average hospitalization expenses of the highest cost group were 22128.45 yuan,and the upper limit of expenses was 78405.33 yuan.Conclusion:The hospitalization expenses of hospitalized children aged 0-6 years in Xinjiang due to road traffic injuries are relatively high.It is reasonable to use the quantile regression and CHAID decision tree model to construct the hospitalization expenses grouping of children with road traffic injuries,and the expense standard can provide reference for hospitals and medical insurance institutions in this region to formulate policies.

关 键 词：医院管理 住院费用 道路交通伤害 儿童 新疆 

分 类 号：R-05[医药卫生] R197.3