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目的比较不同病例分型子宫下段剖宫产患者住院费用差异,分析子宫下段剖宫产住院费用影响因素,为医疗费用控制提供参考。方法选取某三甲医院2015年6月1日-2016年5月31日共2820例子宫下段剖宫产住院患者,应用计算机初筛,结合专家病案复判,确定分型后方差分析、结构变动度比较各组费用和结构差异,最后多元线性回归分析住院费用影响因素。结果病例分型后A型、B型、C型、D型分别为1155例、920例、392例、353例。方差分析提示不同组间住院费用间有差异(F=106.392)。结构变动度分析提示各组间费用结构变动从大到小依次为A-D(33.06),B-D(30.34),A-C(18.83),B-C(18.38),C-D(17.99),A-B(3.68)。多元回归分析提示影响住院费用因素为入院情况、住院天数、并发症和合并症情况、病例分型。结论基于病例分型对病种费用的判定科学、便捷、合理,可为医疗政策改革提供参考。
Objective To compare the differences in hospitalization costs of cesarean section patients under different subtypes of hysteroscopy and to analyze the influencing factors of hospitalization costs of cesarean section in the lower uterine segment to provide references for the control of medical expenses. Methods A total of 2820 inpatients with cesarean section in the lower uterine segment of a top three hospital from June 1, 2015 to May 31, 2016 were enrolled in this study. The computerized screening and expert reexamination were used to determine the variance after analysis. Compare the cost and structure difference of each group, and finally analyze the influencing factors of hospitalization expenses by multiple linear regression. Results The number of type A, type B, type C and type D were 1155, 920, 392 and 353 respectively after the classification. Analysis of variance showed differences in hospitalization costs between different groups (F = 106.392). The results of structural variance analysis show that the cost structure changes among the groups are A-D (33.06), B-D (30.34), A-C (18.83), B-C (18.38), C-D (17.99) and A-B (3.68) in descending order. Multivariate regression analysis suggested that the factors influencing hospitalization costs were hospital admission, hospitalization days, complications and complications, and case classification. Conclusion The judgment of the cost of illness based on case type is scientific, convenient and reasonable, which can provide reference for the reform of medical policy.