论文部分内容阅读
目的分析归纳2011-2014年常州市武进区某医院农村医疗保险患者与自费患者的住院费用及影响因素。方法按性别、住院天数、手术情况、年龄、年份等因素对样本进行单因素分析,比较不同特征人群的住院费用及构成,并以多元回归模型分析住院费用的影响因素。结果⑴农保或自费患者,住院费用四个年度差异均有统计学意义(Uc=2.132~7.843,P<0.05);⑵单因素分析显示:农保患者,性别、住院天数、手术情况、年龄、年份对住院费用的影响差异有统计学意义(P<0.05);自费患者,性别、住院天数、手术情况对住院费用的影响差异有统计学意义(P<0.05);⑶多因素分析显示:影响农保患者住院费用的主要因素为:住院天数(标准化回归系数b~t=0.451,t=145.92,P<0.001)、手术情况(b~t=0.269,t=86.64,P<0.001)、年龄(b~t=0.201,t=65.80,P<0.001)、年份(b~t=-0.084,t=27.91,P<0.001)、性别(b~t=-0.200,t=-6.685,P<0.001)。影响自费患者住院费用的主要因素为:年龄(b~t=0.265,t=140.55,P<0.001)、手术情况(b~t=0.507,t=131.98,P<0.001)、住院天数(b~t=0.029,t=127.60,P<0.001)、年份(b~t=0.018,t=10.23,P<0.001)和性别(b~t=-0.023,t=-6.31,P<0.001)。年龄大、住院天数长、手术、女性、住院年份靠后的患者住院费用和自费费用高。结论住院天数、是否手术及年龄为影响农村医疗保险患者与自费患者住院费用的主要因素,控制农保患者住院费用过快增长应减少无效住院日、降低手术率及费用,引导患者及早就医。在保证服务质量的前提下,农保患者的住院费用控制重点应放在缩短住院天数、合理控制药费、检查费的比例上。
Objective To analyze and summarize the hospitalization expenses and the influencing factors of rural medical insurance patients and patients at their own expense in a hospital in Wujin District, Changzhou from 2011 to 2014. Methods Univariate analysis of the samples according to gender, hospitalization days, surgery, age, year and other factors were used to compare the hospitalization expenses and the constitution of different characteristics of the population. The multiple regression model was used to analyze the influencing factors of hospitalization expenses. Results (1) The annual differences of hospitalization expense and hospitalization expense were statistically significant (Uc = 2.132-7.843, P <0.05). (2) Univariate analysis showed that the number of days of hospitalization, gender, length of hospital stay, (P <0.05). There was significant difference in the influence of hospitalization cost between the self-pay patients, gender, hospitalization days and operation conditions (P <0.05). (3) Multivariate analysis showed that: The main factors influencing the hospitalization expenses of hospital-health insurance patients were hospitalization days (standardized regression coefficient b ~ t = 0.451, t = 145.92, P <0.001), operation conditions (b ~ t = 0.269, t = 86.64, P <0.001) Age (b ~ t = 0.201, t = 65.80, P <0.001), year (b ~ t = -0.084, t = 27.91, P <0.001) <0.001). The main factors influencing the hospitalization expenses of self-pay patients were as follows: age (b ~ t = 0.265, t = 140.55, P <0.001) t = 0.029, t = 127.60, P <0.001), year (b ~ t = 0.018, t = 10.23, P <0.001) and sex (b ~ t = -0.023, t = -6.31, P <0.001). Age, hospitalization days, surgery, women, hospitalized patients with later years of hospitalization costs and high costs. Conclusions The days of hospitalization, operation and age are the main factors that affect the hospitalization expenses of rural medical insurance patients and patients at their own expense. To control the excessive growth of hospitalization expenses of agricultural insurance patients should reduce the invalid hospitalization days, reduce the operation rate and costs, and guide patients to get medical treatment as soon as possible. In ensuring the quality of services under the premise of the cost of hospitalization of patients with pest control should focus on shortening the length of stay in hospital, reasonable control of drug costs, the proportion of inspection fees.