基于多水平模型的心血管患者高额住院费用影响因素研究  

Study on the Influencing Factors of High Hospitalization Costs of Cardiovascular Patients based on a Multilevel Model

作　　者：王寓凡 周晓媛 吴妮 唐金凤 张昭 WANG Yufan;ZHOU Xiaoyuan;WU Ni;TANG Jinfeng;ZHANG Zhao(West China school of Public Health/West China Fourth Hospital,Sichuan University,Chengdu Sichuan 610041,China;不详)

机构地区：[1]四川大学华西公共卫生学院/华西第四医院,四川成都610041

出　　处：《卫生经济研究》2025年第2期55-58,共4页

基　　金：科技部国家重点研发计划“健康管理综合服务应用示范”(2020YFC2006500);四川省软科学研究计划项目“老龄化对城镇职工医保基金利用的影响及变化规律研究”(2015ZR0209);成都市DRG支付方式改革研究采购项目“成都市DRG支付方式改革研究”(SQBX-2023-1105)。

摘　　要：目的:分析心血管患者高额住院费用的影响因素,为完善医疗费用管控政策提供参考依据。方法:根据3 910例高额住院费用病例数据,运用多水平模型分析各因素对高额住院费用的影响。结果:心血管患者高额住院费用构成中,药品费占比最高(44.91%),其次为检查费和材料费;多水平模型分析结果表明,住院天数、手术等级、是否DRG付费、医院类型和医院等级是高额住院费用的重要影响因素。结论:DRG付费在控制高额住院费用方面有积极作用,医保部门应根据医院性质及等级实施差异化管理策略,医院应积极缩短住院天数、合理控制药品和耗材费用,特别关注异常病例的剖析和监控,实现精准控费。Objective To analyze the influencing factors of high hospitalization costs of cardiovascular patients,and to provide reference for improving the control policy of medical costs.Methods Based on the data of 3 910 cases with high hospitalization costs,a multilevel model was used to analyze the influence of various factors on high hospitalization costs.Results Among the high hospitalization costs of cardiovascular patients,drug expenses accounted for the highest proportion(44.91%),followed by examination costs and material costs.The results of the multilevel model analysis indicated that the length of hospital stay,surgery grade,whether DRG payment,hospital type,and hospital grade significantly affected hospitalization costs.Conclusion DRG payment plays a positive role in controlling high hospitalization costs.Medical insurance departments should implement differentiated management strategies according to the nature and grade of hospitals.Hospitals should actively shorten hospitalization days,reasonably control the costs of drugs and consumables,and pay special attention to the analysis and monitoring of abnormal cases to achieve accurate control of costs.

关 键 词：心血管疾病 高额住院费用 多水平模型 

分 类 号：R19[医药卫生—卫生事业管理]