基于多元回归分析的住院费用影响因素研究
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摘要
目的分析重庆市患者住院费用的影响因素。方法运用SQL Server 2008R2提取2014-2015年出院病人量前15位医院的2 167 818例住院患者相关信息,并对数据进行预处理,再运用SAS9.2软件,通过方差分析对各因素分类间进行单因素分析,通过多元线性逐步回归法分析住院费用影响因素。结果性别、年龄、住院时间、是否抢救、是否输血、入院病情、离院方式、操作类别、有无其他诊断9个因素与住院费用相关,差异有统计学意义(P<0.000 1);各因素对住院费用影响从大到小依次为住院时间、操作类别、是否输血、年龄、离院方式、有无其他诊断、性别、是否抢救、入院病情。结论住院时间、操作类别、是否输血可能是住院费用最重要的影响因素。
Objective To analyze the influencing factors of hospitalization expenses of patients in Chongqing.Methods SQL Server 2008 R2 was used to extract information on 2 167 818 inpatients from the top 15 hospitals discharged from 2014 to 2015,and the data was pre-processed.Then SAS9.2 software was used to analyze the factors among the categories by analysis of variance.Univariate analysis was used to analyze the influencing factors of hospitalization expenses by multiple linear stepwise regression.Results Gender,age,hospitalization days,whether to rescue,whether blood transfusion,admission,hospitalization,operation,and other factors were associated with hospitalization costs,the difference was statistically significant(P<0.000 1);According to the importance degree,the influencing factors related to hospitalization expenses were hospitalization time,operation type,blood transfusion,age,hospitalization method,presence or absence of other diagnosis,gender,rescue,admission condition.Conclusion Hospitalization time,type of operation,and whether blood transfusion might be the most important factor in hospitalization costs.
Objective To analyze the influencing factors of hospitalization expenses of patients in Chongqing.Methods SQL Server 2008 R2 was used to extract information on 2 167 818 inpatients from the top 15 hospitals discharged from 2014 to 2015,and the data was pre-processed.Then SAS9.2 software was used to analyze the factors among the categories by analysis of variance.Univariate analysis was used to analyze the influencing factors of hospitalization expenses by multiple linear stepwise regression.Results Gender,age,hospitalization days,whether to rescue,whether blood transfusion,admission,hospitalization,operation,and other factors were associated with hospitalization costs,the difference was statistically significant(P<0.000 1);According to the importance degree,the influencing factors related to hospitalization expenses were hospitalization time,operation type,blood transfusion,age,hospitalization method,presence or absence of other diagnosis,gender,rescue,admission condition.Conclusion Hospitalization time,type of operation,and whether blood transfusion might be the most important factor in hospitalization costs.
引文
[1]袁继梅,张宁.剖宫产住院费用构成及影响因素分析[J].中国卫生统计,2017,34(3):490-491.
[2]国家卫生计生委体制改革司.关于印发控制公立医院医疗费用不合理增长的若干意见的通知[EB/OL].[2015-11-06].http://www.nhfpc.gov.cn/tigs/s3577/201511/0038da2bf8fe43d69511fb675e205d37.shtml.
[3]国家卫生计生委体制改革司.关于尽快确定医疗费用增长幅度的通知[EB/OL].[2016-06-20].http://www.nhfpc.gov.cn/tigs/s3581/201606/899f874f964146 1391fb 0550c997a453.shtml.
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[5]赵忠毅,刘洋,任莹,等.沈阳市某三甲医院糖尿病患者住院费用及影响因素分析[J].中国卫生统计,2015,32(6):926-928.
[6]金琦,何其勇,赵云波,等.1 540例肝硬化患者住院费用影响因素分析[J].中国卫生统计,2015,33(1):91-93.
[7]薛允莲.Logistic回归结合决策树技术在冠心病患者住院费用组合分析中的应用[J].中国卫生统计,2015,32(6):988-992.
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[9]吕晓峰,方红,王春花,等.大连市某三甲医院胆囊切除患者住院费用影响因素分析[J].重庆医学,2017,46(11):1565-1568.
[10]刘平,陈登国.2005-2014年重庆市江北区精神分裂症患者住院费用调查分析[J].重庆医学,2016,45(16):2252-2254.
[11]肖梦,冯向先,张云兵,等.山西省2003-2012年胃癌患者住院费用影响因素分析[J].中国公共卫生,2015,31(10):1330-1333.
[12]杨耀淞,孙常洁,梁超,等.不同医保类型脑出血患者住院费用影响因素综合分析[J].中国卫生经济,2017,36(5):26-28.
[13]韩耀风,高宪利,周莹,等.基于递归系统模型的宫颈癌患者住院费用影响因素分析[J].中国卫生统计,2017,32(2):253-256,259.
[14]重庆市统计局.2017年重庆市国民经济和社会发展统计公报[EB/OL].[2018-03-17].http://www.cqtj.gov.cn/tjsj/sjjd/201803/t20180317_447980.htm.
[15]国家统计局.中华人民共和国2017年国民经济和社会发展统计公报[EB/OL].[2018-02-28].http://www.stats.gov.cn/tjsj/zxfb/201802/t20180228_1585631.html.
[16]范冬冬,姚自勤,王锦权,等.参保脑卒中患者住院费用影响因素分析[J].中国公共卫生,2016,32(12):1745-1749.
[2]国家卫生计生委体制改革司.关于印发控制公立医院医疗费用不合理增长的若干意见的通知[EB/OL].[2015-11-06].http://www.nhfpc.gov.cn/tigs/s3577/201511/0038da2bf8fe43d69511fb675e205d37.shtml.
[3]国家卫生计生委体制改革司.关于尽快确定医疗费用增长幅度的通知[EB/OL].[2016-06-20].http://www.nhfpc.gov.cn/tigs/s3581/201606/899f874f964146 1391fb 0550c997a453.shtml.
[4]董景五,薛欣.疾病和有关健康问题的国际统计分类第十次修订本第一卷[M].北京:人民卫生出版社,2015:21-85.
[5]赵忠毅,刘洋,任莹,等.沈阳市某三甲医院糖尿病患者住院费用及影响因素分析[J].中国卫生统计,2015,32(6):926-928.
[6]金琦,何其勇,赵云波,等.1 540例肝硬化患者住院费用影响因素分析[J].中国卫生统计,2015,33(1):91-93.
[7]薛允莲.Logistic回归结合决策树技术在冠心病患者住院费用组合分析中的应用[J].中国卫生统计,2015,32(6):988-992.
[8]杜亚玲,王忠,郭恒,等.2型糖尿病患者住院费用影响因素的回归分析[J].中国卫生统计,2014,31(3):446-447,449.
[9]吕晓峰,方红,王春花,等.大连市某三甲医院胆囊切除患者住院费用影响因素分析[J].重庆医学,2017,46(11):1565-1568.
[10]刘平,陈登国.2005-2014年重庆市江北区精神分裂症患者住院费用调查分析[J].重庆医学,2016,45(16):2252-2254.
[11]肖梦,冯向先,张云兵,等.山西省2003-2012年胃癌患者住院费用影响因素分析[J].中国公共卫生,2015,31(10):1330-1333.
[12]杨耀淞,孙常洁,梁超,等.不同医保类型脑出血患者住院费用影响因素综合分析[J].中国卫生经济,2017,36(5):26-28.
[13]韩耀风,高宪利,周莹,等.基于递归系统模型的宫颈癌患者住院费用影响因素分析[J].中国卫生统计,2017,32(2):253-256,259.
[14]重庆市统计局.2017年重庆市国民经济和社会发展统计公报[EB/OL].[2018-03-17].http://www.cqtj.gov.cn/tjsj/sjjd/201803/t20180317_447980.htm.
[15]国家统计局.中华人民共和国2017年国民经济和社会发展统计公报[EB/OL].[2018-02-28].http://www.stats.gov.cn/tjsj/zxfb/201802/t20180228_1585631.html.
[16]范冬冬,姚自勤,王锦权,等.参保脑卒中患者住院费用影响因素分析[J].中国公共卫生,2016,32(12):1745-1749.