转诊患者治疗床位和康复床位医疗费用影响因素分析
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摘要
目的分析转诊患者治疗床位、康复床位、就医全程住院费用及影响因素,探索床位分类管理制度下的支付方式。方法回顾性分析2013年1月1日-2016年8月31日治疗床位和康复床位的患者的病案首页数据,通过单因素和多因素分析,找出各阶段医疗费用的影响因素。结果治疗床位住院费用为39 728(28 306,52 429)元,康复床位住院费用为6 441(4 143,8 407)元,就医全程住院费用为47 558(34 641,60 787)元。出院年份、主诊断、治疗床位住院日、康复床位住院日、康复床位手术个数等变量对各阶段医疗费用均有显著影响。结论城镇职工医保患者康复床位住院费用比全自费患者高;医疗费用有所增长;治疗床位和康复床位住院费用相互关联。
Objective To analyze patients' cost and associated factors in therapeutic beds,rehabilitation beds and the total expense,and to provide evidence for payment by bed classification management system. Methods Data on the first page of medical records of patients in therapeutic beds and rehabilitation beds from January 1,2013 to August31,2016 were collected and retrospectively analyzed.Univariate and multivariate analyses were adopted to identify major associated factors of patients' costs of each stage. Results The costs of therapeutic beds and rehabilitation beds were39 728(28 306,52 429)Yuan and 6 441(4 143,8 407)Yuan,and the total cost was 47 558(34 641,60 787)Yuan.Discharge year,major diagnosis,length of stay in therapeutic beds and rehabilitation beds,the surgery number of rehabilitation beds had significant impact on the costs of each medical stages. Conclusion Cost of patients with medical insurance for urban workers in rehabilitation beds was higher than that of self-paying patients,and the cost had increased.Cost of therapeutic beds and rehabilitation beds were interrelated.
Objective To analyze patients' cost and associated factors in therapeutic beds,rehabilitation beds and the total expense,and to provide evidence for payment by bed classification management system. Methods Data on the first page of medical records of patients in therapeutic beds and rehabilitation beds from January 1,2013 to August31,2016 were collected and retrospectively analyzed.Univariate and multivariate analyses were adopted to identify major associated factors of patients' costs of each stage. Results The costs of therapeutic beds and rehabilitation beds were39 728(28 306,52 429)Yuan and 6 441(4 143,8 407)Yuan,and the total cost was 47 558(34 641,60 787)Yuan.Discharge year,major diagnosis,length of stay in therapeutic beds and rehabilitation beds,the surgery number of rehabilitation beds had significant impact on the costs of each medical stages. Conclusion Cost of patients with medical insurance for urban workers in rehabilitation beds was higher than that of self-paying patients,and the cost had increased.Cost of therapeutic beds and rehabilitation beds were interrelated.
引文
[1]金超,熊晨雪,陈海乐,等.康复床位空间分布需求和供需匹配程度测算方法研究[J].中国医院管理,2016,36(5):17-19.
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[3]周文,张开金,汤仕忠.医保患者和自费患者住院医疗费用比较分析[J].江苏卫生保健,2009,11(3):3-4,7.
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[7]陈治水,高广颖,王力红,等.股骨颈骨折住院费用结构及其影响因素灰色关联分析[J].中国卫生经济,2012,31(3):59-61.
[8]程雷,牟卿,潘新,等.骨科颈椎病病人住院费用及影响因素分析[J].中国卫生统计,2011(5):576-577.
[2]朱洁,金萍妹,华伟,等.15 348例宫颈癌不同治疗方式的住院费用研究[J].中国医院管理,2017,37(2):58-60.
[3]周文,张开金,汤仕忠.医保患者和自费患者住院医疗费用比较分析[J].江苏卫生保健,2009,11(3):3-4,7.
[4]姚中宝,孙玉凤,吴翠颖,等.不同医疗保险制度对住院费用影响的比较研究[J].中国农村卫生事业管理,2016,36(2):149-151.
[5]凌卓,郑翔,赵珊,等.脊柱外科住院费用影响因素分析[J].中国卫生质量管理,2015,22(2):31-33.
[6]国家卫生和计划生育委员会.中国卫生和计划生育统计年鉴(2016)[M].北京:中国协和医科大学出版社,2016:105.
[7]陈治水,高广颖,王力红,等.股骨颈骨折住院费用结构及其影响因素灰色关联分析[J].中国卫生经济,2012,31(3):59-61.
[8]程雷,牟卿,潘新,等.骨科颈椎病病人住院费用及影响因素分析[J].中国卫生统计,2011(5):576-577.