摘要
目的探讨手术患者住院费用的构成与影响因素,为合理控制手术患者住院费用提供参考依据。方法收集某医院2015年1月1日-2019年12月31日手术患者的住院费用及病案首页信息,分析住院费用构成及变化趋势,采用单因素和多因素分析方法分析住院费用的影响因素。结果手术患者住院费用呈逐年上升趋势,住院费用构成中排名前3位的分别为材料费(32.91%)、药品费(26.41%)和手术费(9.69%)。多因素分析结果显示性别、年龄、婚姻状况、付费方式、入院途径、住院天数、是否抢救、术前住院天数、出院情况、手术级别和出院年份均为手术患者产生较高住院费用的显著影响因素,男性、高龄、婚姻状况为已婚/丧偶/离异、自费患者、入院途径为急诊/转入/其他、有抢救、住院天数和术前住院天数越长、出院情况为未治愈以及出院年份越大的患者,越容易产生较高的住院费用。结论加强医用耗材的规范化管理,通过合理安排术前检查、改善围手术期的处理、预防术后并发症的发生等措施合理控制术前住院天数和住院天数。
Objectives To explore the composition and influencing factors of the hospitalization expenses of surgery patients,so as to provide reference for rational control of the hospitalization expenses of surgery patients.Methods The information of hospitalization expenses and the front page of medical records of surgical patients in a hospital from January 1st,2015 to December 31st,2019 were collected to analyze the composition and trend of hospitalization expenses.The influencing factors of hospitalization expenses were analyzed by using single-factor and multi-factor analysis methods.Results The hospitalization expenses of surgical patients showed an increasing trend year by year,and the top three hospitalization expenses were materials(32.91%),drugs(26.41%)and surgery(9.69%).The results of multivariate analysis showed that gender,age,marital status,medical payment method,admission route,hospitalization days,whether to rescue,waiting days before surgery,discharge status,surgical grade and discharge year were all significant factors influencing the higher hospitalization costs of surgical patients.Among them,male patients,old age,married/widowed/divorced patients,self-funded patients,patients admitted by emergency/transfer/other means of admission,patients with emergency treatment,longer hospitalization days and preoperative length of stay,patients with untreated discharge,and patients with larger discharge year are more likely to incur higher hospitalization costs.Conclusions We should strengthen the standardized management of medical consumables,rationally control the number of days in hospital before operation and the number of days in hospital by reasonably arranging preoperative examination,improving perioperative treatment and preventing postoperative complications.
作者
吴梦平
刘萍
徐渭
倪爱琳
张骞峰
Wu Mengping;Liu Ping;Xu Wei;Ni Ailin;Zhang Qianfeng(Quality and Safety Management Office,The First People's Hospital of Lianyungang,Lianyungang 222061,Jiangsu Province,China)
出处
《中国病案》
2021年第9期76-80,共5页
Chinese Medical Record
基金
连云港市第一人民医院青年英才基金项目(QN1916)
南京医科大学康达学院2020年度科研发展基金课题(KD2020KYJJYB083)。
关键词
手术患者
住院费用
影响因素
Surgical patients
Hospitalization expenses
Influencing factors
