基于递归系统模型的乙肝患者住院费用影响因素分析  

Analysis of influencing factors of hepatitis B patients hospitalization cost based on recursive system model

作　　者：魏延萍[1] 刘思敏 张亚南[3,4] 丁国武 张树海[2] WEI Yanping;LIU Simin;ZHANG Yanan;DING Guowu;ZHANG Shuhai(The First Hospital of Lanzhou University,Gansu,Lanzhou 730000,China;School of Public Health,Lanzhou University,Gansu,Lanzhou 730000,China;Center for Health Management and Health Development,Lanzhou University,Gansu,Lanzhou 730000,China;Gansu Province Center for Family Planning and Reproductive Health Technology,Gansu,Lanzhou 730000,China)

机构地区：[1]兰州大学第一医院消化科,甘肃兰州730000 [2]兰州大学第一医院监察处,甘肃兰州730000 [3]兰州大学公共卫生学院,甘肃兰州730000 [4]兰州大学卫生管理与健康发展中心,甘肃兰州730000 [5]甘肃省计划生育科学技术服务中心,甘肃兰州730000

出　　处：《社区医学杂志》2024年第24期847-853,共7页Journal Of Community Medicine

基　　金：中央高校战略项目(2022jbkyzx012)。

摘　　要：目的统计兰州大学第一医院乙肝患者住院费用情况并分析其影响因素,为降低乙肝住院费用提供理论支撑依据。方法选取2016-01-01-2022-12-31兰州大学第一医院乙肝病案首页信息数据,终纳入乙肝住院病例6027例。采用SPSS 25.0软件对数据进行统计学分析,运用多元逐步回归分析和路径分析方法对影响住院费用的影响因各种要素进行分析。结果共纳入6027例乙肝患者,住院总费用为14432.95万元,例均住院费用均数为24487.52元。住院费用主要构成为综合医疗服务类(16.36%)、诊断费(5.60%)、治疗费(2.88%)、康复费(0.30%)、药品费(39.53%)、血液和血液制品费(13.58%)、耗材费(7.84%)、其他费(13.91%)。路径模型分析结果显示,住院天数是住院费用的首要影响因素,总效应值为0.734。结论兰州大学第一医院乙肝住院病例的住院费用负担较重,需进一步降低药品费用,同时落实分级诊疗制度、合理缩短住院天数。Objective To analyze the hospitalization costs of hepatitis B patients in a tertiary hospital in Lanzhou and to analyze the influencing factors,so as to provide theoretical support for reducing the hospitalization costs of hepatitis B.Methods The data of this study were derived from the information data of the first page of the medical records of a tertiary hospital in Lanzhou City,Gansu Province,and the data of the first page of the medical records of hepatitis B from January 1,2016 to December 31,2022 were selected.SPSS 25.0 software tools were used to process the data,and multiple stepwise regression analysis and path analysis methods were used to analyze the factors affecting hospitalization costs.Results A total of 6027 hospitalized patients with hepatitis B were included,and the total hospitalization cost was 144.3295 million yuan,and the average hospitalization cost was 24487.52 yuan.Hospitalization expenses were mainly composed of comprehensive medical services(16.36%),diagnosis(5.60%),treatment(2.88%),rehabilitation(0.30%),drugs(39.53%),blood and blood products(13.58%),consumables(7.84%),and other expenses(13.91%).The results of pathway model analysis showed that the number of days of hospital stay was the primary factor influencing the cost of hospitalization,with a total effect size of 0.734.Conclusion The burden of hospitalization expenses of inpatient cases of hepatitis B in a tertiary hospital in Lanzhou is relatively heavy,and it is necessary to further reduce the drug cost,implement the hierarchical diagnosis and treatment system,and reasonably shorten the length of hospitalization.

关 键 词：乙肝 住院费用 住院天数 影响因素 路径分析 

分 类 号：R195.4[医药卫生—卫生统计学]