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目的:利用HIS系统信息,研究不同支付方式下医疗费用结构的变动规律,为制定医疗费用结构控制措施提供理论依据和方法学基础。方法:运用球坐标变换方法,以上海市某综合性三甲医院2007—2010年住院患者费用的变动情况为例进行分析。结果:不同支付方式下的药品费和手术费均占较大比重,且自费患者比医保患者更高。随时间变化,药品费构成呈下降趋势,手术费构成呈上升趋势。自费患者除输血费转换角与时间无线性回归外,其他各项费用均有统计学意义;医保患者除治疗费和输血费转换角与时间无线性回归外,其他各项费用均有统计学意义。结论:可以通过HIS系统进行数据挖掘。采用球坐标变换用于医疗费用成分数据资料是可行的。社会医疗保险体系正逐步步入正轨,医保患者住院费用得到了一定的控制。
OBJECTIVE: To study the change rule of medical cost structure under different payment methods by using HIS system information, and to provide theoretical basis and methodological basis for formulating medical cost structure control measures. Methods: The spherical coordinate transformation method was used to analyze the changes of inpatients’ costs from 2007 to 2010 in a comprehensive top three hospital in Shanghai. Results: The costs of medicines and surgeries under different payment methods accounted for a large proportion, and patients with medical expenses at their own expense were higher than those with Medicare. Over time, drug costs constitute a downward trend, the operating costs constitute an upward trend. In addition to patients with their own cost of blood transfusion conversion angle and the time of non-linear regression, the other costs were statistically significant; Medicare patients in addition to treatment costs and blood transfusion conversion angle and time of non-linear regression, the other costs were statistically significant . Conclusion: Data mining can be done through the HIS system. It is feasible to use the spherical coordinate transform for medical cost component data. Social medical insurance system is gradually getting on the right track, and hospitalization expenses for medical insurance patients have been controlled.