DRG支付下泌尿外科超支病例住院费用影响因素研究  

Study on the influencing factors of excess hospitalization expenses of patients in urology under DRG payment

作　　者：丁晨晨 余进 辛学瑾 李力 阙楚楚 朱雅萍 杨子涵 DING Chenchen;YU Jin;XIN Xuejin;LI Li;QUE Chuchu;ZHU Yaping;YANG Zihan(Nanjing Drum Tower Hospital,Nanjing Jiangsu 280000,China)

机构地区：[1]南京鼓楼医院,江苏南京280000

出　　处：《卫生软科学》2024年第12期6-9,共4页Soft Science of Health

基　　金：南京市卫生科技发展专项资金项目计划(GAX22279)。

摘　　要：[目的]探究泌尿外科超支病例住院费用的影响因素,为医疗机构控制超支费用,制定医院高质量发展政策提供参考。[方法]以南京市某三甲医院泌尿外科超支病例为例,使用单因素分析以及结构方程模型分析超支病例住院费用的影响因素。[结果]是否使用机器人辅助对泌尿外科超支病例住院费用的影响为0.525,是否伴有并发症对超支费用的影响为-0.314,次手术数量对超支费用的影响为0.168,住院天数对超支费用的影响为0.122,基金类型对超支费用的影响为0.071,年龄对超支费用的影响为-0.047。[结论]是否使用机器人辅助对泌尿外科超支费用的影响最大,住院天数不仅会影响超支费用,还会正向影响其他因素与超支费用的关系;泌尿外科不伴并发症的住院超支费用普遍高于伴并发症的住院超支费用。Objective To analyze the influencing factors of excess hospitalization expenses of patients in urology,and to provide the reference for medical institutions to control overspending and formulate high-quality development policies for hospitals.Methods Taking the cases of overspending in urology of a third-grade hospital in Nanjing as an example,the influencing factors of overspending were analyzed by single factor analysis and structural equation model.Results The effect of robot assistance on excess hospitalization expenses of patients in urology was 0.525.The impact of complications on cost overrun was-0.314.The impact of the number of operations on cost overrun was 0.168.The impact of hospital days on cost overrun was 0.122.The impact of fund types on cost overrun was 0.071.The effect of age on cost overrun was-0.047.Conclusions The use of robot assistance has the greatest impact on the overspending in urology department.The hospital length of stay not only affects the cost overrun,but also positively affects the relationship between other factors and cost overrun.Excess hospitalization expenses of patients in urology without complications are generally higher than that of patients with complications.

关 键 词：DRG付费方式改革 泌尿外科 超支费用 结构方程模型 

分 类 号：R197.1[医药卫生—卫生事业管理]