18563例老年人跌倒住院费用及影响因素的通径分析  

Path Analysis of Hospitalization Costs and Influencing Factors for 18563 Cases of Elderly Falls

作　　者：陈小润 尚文茹 李萍 狄建忠 Chen Xiaorun;Shang Wenru;Li Ping;Di Jianzhong(Department of Medical Affairs,Shanghai Sixth People's Hospital,Shanghai 200233,China;不详)

机构地区：[1]国家骨科医学中心,上海市200233 [2]上海市第六人民医院医务处,上海市200233 [3]上海市第六人民医院医院管理研究中心,上海市200233 [4]上海市养志康复医院院长办公室,上海市201619 [5]上海市第六人民医院院长室,上海市200233

出　　处：《中国病案》2025年第2期70-75,共6页Chinese Medical Record

基　　金：上海交通大学智库引导性研究项目(ZKYJ-2022009)。

摘　　要：目的了解老年人跌倒患者的住院费用构成及影响因素,为合理控制住院费用,优化医疗服务价格体系提供参考依据。方法收集上海市某公立三甲医院2021年1月1日-2023年12月31日18563例老年人跌倒住院患者病案信息,对其住院费用构成进行描述性分析,并采用秩和检验、多元回归分析、通径分析等方法探讨其住院费用的直接和间接影响因素,并对各因素的总效应进行排序。结果老年人跌倒患者住院费用中位数为5.03万元,耗材费用(63.38%)和治疗费用(20.73%)占比大。手术影响的总效应占0.93。结论老年人跌倒住院费用耗材费用占比较高,手术是最重要的影响因素。为有效控制住院费用,医院应继续推行耗材集中带量采购政策、优化手术流程、推行DRG付费制度等措施。Objectives To understand the composition and influencing factors of hospitalization costs for elderly falls,and provide a reference for the rational control of hospitalization costs and the optimization of the medical service price system.Methods A total of 18,563 cases of elderly falls hospitalization patient medical records from January 1st,2021,to December 31st,2023,were collected.Descriptive statistical analysis was conducted on the composition of hospitalization costs,and methods such as rank sum test,multiple regression analysis,and path analysis model were used to explore the direct and indirect factors affecting hospitalization costs and to rank the total effects of each factor.Results The median inpatient cost for elderly falls patients in a public Three A and Tertiary Hospital in Shanghai was 50,300 yuan,with consumables(63.38%)and treatment costs(20.73%)accounting for the largest proportion.The total effect of surgery on costs was 0.93.Conclusions The cost of consumables for elderly falls hospitalizations was relatively high,and surgery was the most significant influencing factor.To effectively control inpatient costs,hospitals should continue to implement centralized bulk procurement policies for consumables,optimize surgical processes,and implement the DRG payment system.

关 键 词：老年人 跌倒 住院费用 影响因素 通径分析 

分 类 号：R197.1[医药卫生—卫生事业管理]