4848例高血压患者住院费用结构及影响因素分析  

Analysis on the Hospitalization Cost Structure and Influencing Factors of 4848 Hypertensive Patients

作　　者：李小燕 周燕 许静怡[1] Li Xiaoyan;Zhou Yan;Xu Jingyi(School of Humanities and Management,Ningxia Medical University,Y inchuan 750000,Ningxia Hui Autonomous Region,China;不详)

机构地区：[1]宁夏医科大学人文与管理学院,宁夏回族自治区银川市750000

出　　处：《中国病案》2025年第2期62-66,共5页Chinese Medical Record

基　　金：宁夏自然科学基金(2022AAC03233)。

摘　　要：目的 对某院高血压患者的住院费用构成与影响因素进行分析,为合理控制患者住院费用提供参考依据。方法 于2023年8月收集医院2020年1月1日-2022年12月31日4 848例高血压患者的住院费用信息,采用灰色关联法及结构变动度分析患者住院费用的结构变化及各项费用与住院总费用间的关联度;多重线性回归分析患者的住院费用影响因素。结果 2020年-2022年间高血压人均住院费用整体呈下降趋势,人均转费用为14 000.6元。西药费、治疗费、化验费、材料费在人均住院费用中占比较高,分别为22.14%、17.73%、13.68%、6.95%,诊查费、护理费占比较低,分别为0.63%、2.50%;治疗费(0.9249)、西药费(0.9043)、化验费(0.8400)、材料费(0.7941)与人均住院总费用的关联度较高,护理费、诊查费关联度较低,分别为0.7696、0.7595;除材料费、治疗费、中成药费以及护理费外,其余住院费用均呈正向变动,治疗费对住院费用的结构贡献率最大,检查费次之。年龄、是否采用DIP付费、有无并发症、医保类型、住院天数、高血压级别是住院费用的影响因素(P<0.05)。结论 高血压患者住院费用结构需进一步优化,医院应加强监督管理,规范诊疗行为,合理控制药品费和检查费;加快按病种分值(DIP)付费,适当提高医疗服务费;重视社区慢性病规范化管理,加强宣传教育,提高居民健康知识知晓率,降低高血压发病率。Objectives To analyze the composition and influencing factors of hospitalization cost and provide reference for reasonable control of hospitalization cost.Methods To collect 4848 hypertensive patients from January 1st,2020 to December 31st,2023,and analyze the structure changes between hospitalization cost and the total hospitalization cost of patients.Results From 2020 to 2022,the per capita hospitalization cost of hypertension showed a downward trend,and the per capita transfer cost was 14 000.6 yuan.The cost of western medicine,treatment,laboratory and materials accounted for a relatively high proportion of the per capita hospitalization cost,which were 22.14%,17.73%,13.68%and 6.95%respectively,while the cost of examination and nursing accounted for a relatively low proportion,which were 0.63%and 2.50%respectively.The correlation between treatment fee(0.9249),western medicine fee(0.9043),laboratory fee(0.8400)and material fee(0.7941)was higher than that between nursing fee and examination fee,which were 0.7696 and 0.7595 respectively.In addition to material cost,treatment cost,Chinese medicine cost and nursing cost,the rest of the inpatient costs were positively changed,and the contribution rate of treatment cost to the structure of inpatient costs was the largest,followed by inspection cost.Age,DIP payment,complications,type of medical insurance,length of stay and grade of hypertension were the influencing factors of hospitalization cost(P<0.05).Conclusions The structure of hospital expenses for hypertensive patients should be further optimized.Hospitals should strengthen supervision and management,standardize diagnosis and treatment behavior,and reasonably control drug costs and examination fees,speed up DIP payment and appropriately increase medical service fees.We should attach importance to the standardized management of chronic diseases in communities,strengthen publicity and education,improve residents'awareness of health knowledge,and reduce the incidence of hypertension.

关 键 词：高血压 住院总费用 新灰色关联法 结构变动法 

分 类 号：R544.1[医药卫生—心血管疾病]