地中海贫血患儿住院费用结构变动及影响因素分析  

Analysis of Structural Changes and Influencing Factors of Hospitalization Expenses in Children with Thalassemia

作　　者：吴东彦 杨敏霞 蒋春燕 吴韫宏 Wu Dongyan;Yang Minxia;Jiang Chunyan;Wu Yunhong(School of Information and Management,Guangxi Medical University,Nanning 530021,Guangxi Zhuang Autonomous Region,China;不详)

机构地区：[1]广西医科大学信息与管理学院,广西壮族自治区南宁市530021 [2]广西大学公共管理学院,广西壮族自治区南宁市530004 [3]广西钦州市第一人民医院,广西壮族自治区钦州市535000 [4]广西医科大学第二附属医院,广西壮族自治区南宁市530007

出　　处：《中国病案》2025年第3期76-80,共5页Chinese Medical Record

基　　金：钦州市科学研究与技术开发计划项目资金资助(2022023A)。

摘　　要：目的分析地中海贫血患儿住院费用的结构变动和影响因素,为制定有效控费方案以减轻患儿及家属的经济负担提供参考和数据支持。方法回顾性分析广西某三甲医院的病案信息系统中2019年1月1日—2023年12月31日出院诊断为地中海贫血且年龄≤18岁的患儿住院病案首页数据。采用描述性分析、单因素分析、新灰色关联、结构变动度和多元逐步线性回归分析地中海贫血患儿住院费用的结构变动和影响因素。结果4138例患儿中78.66%年龄在11岁以内,75.76%患儿住院天数为3天内,97.83%患儿在住院期间进行输血治疗。新灰色关联分析结果显示各项费用关联度从大到小依次是血费(0.92)、医技诊断费(0.84)、医疗服务费用(0.82)、耗材费(0.77)、医疗费用(0.63)、药费(0.57)。结构变动贡献率呈上升趋势的是血费、药费。通过单因素分析和多元逐步线性回归分析得出住院次数、主要诊断、住院天数、年龄、是否输血、DRGs实施情况对住院费用有显著影响,差异具有统计学意义。住院时间越长、年龄越大且有输血的患儿住院费用越高。结论地中海贫血患儿住院人数和住院费用逐年降低,应该继续优化控费方案、避免过度检查、制定输血方案并有效控制输血成本、有效缩短住院天数、创新治疗方案与进行早期干预治疗,从而降低住院费用、减轻患儿及家属的经济负担。Objectives This study aims to analyze influencing factors and structural changes of hospitalization costs in children with thalassemia,and to provide reference and data support for the effective cost control scheme and reduce the economic burden of children and their families.Methods The data on the front page of hospitalized medical records of children aged≤18 years who were discharged with a diagnosis of thalassemia from January 1,2019 to December 31,2023 in the medical record information system of a tertiary hospital in Guangxi were retrospectively analyzed.Descriptive analysis,univariate analysis,new grey correlation,structural change degree and multiple stepwise linear regression were used to analyze the structural changes of hospitalization costs in children with thalassemia and its influencing factors.Results Among the 4,138 children,78.66% were under 11 years,75.76% had hospital days within 3 days,and 97.83% had transfusion therapy during hospitalization.The new grey correlation analysis showed that the relational degree sort order of each average cost from the highest to the lowest were blood fees(0.92),medical technology diagnosis fees(0.84),medical service fees(0.82),material fees(0.77),medical fees(0.63),and drug fees(0.57).The contribution rate of structural change was showing an upward trend among blood costs and drug costs.Through univariate analysis and multiple stepwise linear regression analysis,it was found that the number of hospitalizations,main diagnosis,length of hospitalization,age,whether blood transfusions were performed,and the implementation of DRGs had a significant impact on hospitalization costs,and the differences were statistically significant.Children with longer hospitalization,older age and blood transfusion had higher hospitalization costs.Conclusions The number of hospitalization and hospitalization costs of children with thalassemia decrease year by year.Hospitals should continue to optimize cost control plans,avoid excessive examinations,develop blood transfusion plans an

关 键 词：地中海贫血 住院费用 新灰色关联分析 结构变动度 多元逐步线性回归 

分 类 号：R725.5[医药卫生—儿科]