广东省综合性公立医院住院费用控制策略探讨:基于灰色关联和结构变动度分析
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摘要
目的:探讨广东省综合性公立医院住院费用结构及重要影响费用项目,为优化患者住院费用结构及有效控费提供实证依据。方法:利用灰色关联法、结构变动度评价2015—2017年住院各项费用的关联程度、结构占比及变动情况。结果:2015—2017年,药品费和卫生材料费主要影响住院患者次均费用结构变动。除药品费以外,其次关联系数最大依次是化验费、治疗费。结论:药品费和卫生材料费是影响广东省综合性公立医院医疗费用的主要项目,医疗服务劳务性收入占比较低。建议进一步优化调整费用结构,规范诊疗行为,设计协同控费方案,建立合理有效的控费机制。
Objective: To discuss the hospitalization expense structure and important influencing expense project of comprehensive public hospitals, so as to provide empirical evidence for optimizing the patient hospitalization expense structure and effective cost control. Methods: Grey correlation method and structural change degree analysis were used to evaluate the association degree,structure composition and changes of between the items of hospitalization expenses in 2015—2017. Results: In 2015—2017, the costs of medicines and sanitary materials were the main items causing structural changes in the average cost of medical treatment for inpatients. In addition to the drug fee, the top 3 correlation coefficient were the health material fee, laboratory fee, and treatment fee.Conclusion: The drug and health materials fees were the main items affecting the medical expenses of comprehensive public hospitals in Guangdong. The proportion of labor service income was relatively low. It was suggested to further optimize the adjustment cost structure, standardize the diagnosis and treatment behavior, design a coordinated control fee scheme and establish a reasonable and effective fee control mechanism.
Objective: To discuss the hospitalization expense structure and important influencing expense project of comprehensive public hospitals, so as to provide empirical evidence for optimizing the patient hospitalization expense structure and effective cost control. Methods: Grey correlation method and structural change degree analysis were used to evaluate the association degree,structure composition and changes of between the items of hospitalization expenses in 2015—2017. Results: In 2015—2017, the costs of medicines and sanitary materials were the main items causing structural changes in the average cost of medical treatment for inpatients. In addition to the drug fee, the top 3 correlation coefficient were the health material fee, laboratory fee, and treatment fee.Conclusion: The drug and health materials fees were the main items affecting the medical expenses of comprehensive public hospitals in Guangdong. The proportion of labor service income was relatively low. It was suggested to further optimize the adjustment cost structure, standardize the diagnosis and treatment behavior, design a coordinated control fee scheme and establish a reasonable and effective fee control mechanism.
引文
[1]谭礼萍.住院医疗费用构成的结构变动度分析[J].中国卫生统计,2015,32(3):441-442.
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[5]舒象喜.新灰色关联分析法在医院管理中的应用[J].数理医药学杂志,2000,13(2):172-173.
[6]李静,马效恩,华永新,等.基于结构变动度的不同付费方式住院医疗费用控制研究[J].中国医院管理,2015,35(12):65-67.
[7]徐婷婷,冯俊,高洪达,等. 2014—2016年某大型综合医院住院费用结构变动趋势及特征[J].广西医学,2018,40(8):999-1001.
[8]林凯,李念.浙江省县级公立医院改革对住院次均费用的影响——基于灰色关联和结构变动度分析[J].中国医院管理,2016,36(1):63-65.
[9]张馨遥,李跃平.福州市某儿童医院大额住院费用的影响因素及其控制策略[J].医学与社会,2017,30(1):47-50.
[2]孙振球.医学综合评价方法及其应用[M].化学工业出版社,2006.
[3]杨婷,王玉贵,杨波,等.结构变动度在住院医疗费用结构分析中的应用[J].中国卫生统计,2010,27(1):90-91.
[4]郭敏,靳继斌,郭长满,等.天津市滨海新区流入人口异地就医住院费用结构分析[J].中国卫生统计,2018,35(2):242-245.
[5]舒象喜.新灰色关联分析法在医院管理中的应用[J].数理医药学杂志,2000,13(2):172-173.
[6]李静,马效恩,华永新,等.基于结构变动度的不同付费方式住院医疗费用控制研究[J].中国医院管理,2015,35(12):65-67.
[7]徐婷婷,冯俊,高洪达,等. 2014—2016年某大型综合医院住院费用结构变动趋势及特征[J].广西医学,2018,40(8):999-1001.
[8]林凯,李念.浙江省县级公立医院改革对住院次均费用的影响——基于灰色关联和结构变动度分析[J].中国医院管理,2016,36(1):63-65.
[9]张馨遥,李跃平.福州市某儿童医院大额住院费用的影响因素及其控制策略[J].医学与社会,2017,30(1):47-50.