辽宁省某县级公立医院2014年-2017年2型糖尿病住院费用关联度及结构变动分析
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摘要
目的研究辽宁省某县级公立医院2型糖尿病住院费用的变动情况及变动原因,为控制2型糖尿病住院费用提供合理依据。方法收集2014年1月1日-2017年12月31日间该机构2型糖尿病患者的住院费用资料,运用新灰色关联度与结构变动度方法,对2型糖尿病患者住院费用的各单项费用影响程度及变动情况进行分析。结果新灰色关联度方法得出对住院费用影响程度由强到弱的费用依次为诊疗费、药品费、卫生材料费、其他费用与护理费;结构变动度方法得出诊疗费、卫生材料费与其他费用对住院费用呈正向贡献变动,药品费与护理费对住院费用呈负向贡献变动。结论优化诊疗项目及诊疗方式、深化"药品零差价"制度实施,加强药品成本核算、规范和控制卫生材料使用,可有效减少2型糖尿病患者住院费用。
Objective To study the changes and the reasons for the change of hospitalization expenses for type 2 diabetes in a county-level public hospital in Liaoning Province, and provide a reasonable basis for controlling the hospitalization expenses of type 2 diabetes. Methods The hospitalization expenses data of patients with type 2 diabetes in the institution from January 1, 2014-December 31, 2017 were collected. The new gray correlation degree and structural variation degree method were used to analyze the influence degree and change of each individual cost of hospitalization expenses for type 2 diabetes patients. Results The new gray correlation method shows that the degree of influence on hospitalization expenses is from medical treatment to medical treatment,medicine, health materials, other expenses and nursing expenses. The structural variation method is used to obtain medical expenses, health materials and other expenses. The hospitalization expenses showed a positive contribution change, and the drug and nursing expenses showed a negative contribution to the hospitalization expenses.Conclusion Optimize the diagnosis and treatment programs and Methods of diagnosis and treatment, deepen the implementation of the "zero price difference" system, strengthen drug cost accounting, standardize and control the use of sanitary materials, and effectively control the hospitalization expenses of patients with type 2 diabetes.
Objective To study the changes and the reasons for the change of hospitalization expenses for type 2 diabetes in a county-level public hospital in Liaoning Province, and provide a reasonable basis for controlling the hospitalization expenses of type 2 diabetes. Methods The hospitalization expenses data of patients with type 2 diabetes in the institution from January 1, 2014-December 31, 2017 were collected. The new gray correlation degree and structural variation degree method were used to analyze the influence degree and change of each individual cost of hospitalization expenses for type 2 diabetes patients. Results The new gray correlation method shows that the degree of influence on hospitalization expenses is from medical treatment to medical treatment,medicine, health materials, other expenses and nursing expenses. The structural variation method is used to obtain medical expenses, health materials and other expenses. The hospitalization expenses showed a positive contribution change, and the drug and nursing expenses showed a negative contribution to the hospitalization expenses.Conclusion Optimize the diagnosis and treatment programs and Methods of diagnosis and treatment, deepen the implementation of the "zero price difference" system, strengthen drug cost accounting, standardize and control the use of sanitary materials, and effectively control the hospitalization expenses of patients with type 2 diabetes.
引文
[1]刁文丽,游弋.辽宁省12143名城乡居民慢性病患病现状及主要危险因素分析[J].现代预防医学,2017,44(10):1793-1797,1813.
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[4]刘敏,吴华章.结直肠癌化疗患者住院费用关联度及结构变化分析[J].中国病案,2018,19(05):41-44.
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[6]高洪达,赵劲民,陈荷,等.基于结构变动度的肾结石患者住院费用研究[J].中国病案,2018,19(09):60-63.
[7]肖丽红,黄振宇.2型糖尿病临床路径管理与DRGs国内外发展现状[J].现代医药卫生,2018,34(12):1824-1826.
[8]尹好,杨小玲,徐杰,等.临床路径在2型糖尿病医疗成本控制中的应用与分析[J].四川医学,2018,39(02):235-238
[9]郭伟文,梅文华,郭文燕.某市三级公立医院患者住院费用变化趋势及关联度分析[J].中国病案,2018,19(08):66-70.
[10]李士臻,计立群,姚望,等.辽宁省县级公立医院改革试点对县医院收支的影响[J].中国卫生经济,2016,35(12):80-83.
[11]韩志琰,温楠,宋奎勐,等.山东省公立医院患者医疗费用结构变动分析[J].卫生软科学,2018,32(02):40-45.
[12]郭玉婷,李长平,崔壮,等.2009-2013年天津市参保慢性阻塞性肺疾病患者住院费用结构分析[J].中国卫生统计,2017,34(03):370-373.
[2]胡如英,潘劲,武海滨,等.常见恶性肿瘤归因2型糖尿病风险及医疗经济负担研究[J].预防医学,2017,29(08):762-765.
[3]曾琪,钱毅,林影,等.2型糖尿病医保患者住院费用定额合理性初探[J].卫生经济研究,2018(03):41-43.
[4]刘敏,吴华章.结直肠癌化疗患者住院费用关联度及结构变化分析[J].中国病案,2018,19(05):41-44.
[5]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(02):242-245.
[6]高洪达,赵劲民,陈荷,等.基于结构变动度的肾结石患者住院费用研究[J].中国病案,2018,19(09):60-63.
[7]肖丽红,黄振宇.2型糖尿病临床路径管理与DRGs国内外发展现状[J].现代医药卫生,2018,34(12):1824-1826.
[8]尹好,杨小玲,徐杰,等.临床路径在2型糖尿病医疗成本控制中的应用与分析[J].四川医学,2018,39(02):235-238
[9]郭伟文,梅文华,郭文燕.某市三级公立医院患者住院费用变化趋势及关联度分析[J].中国病案,2018,19(08):66-70.
[10]李士臻,计立群,姚望,等.辽宁省县级公立医院改革试点对县医院收支的影响[J].中国卫生经济,2016,35(12):80-83.
[11]韩志琰,温楠,宋奎勐,等.山东省公立医院患者医疗费用结构变动分析[J].卫生软科学,2018,32(02):40-45.
[12]郭玉婷,李长平,崔壮,等.2009-2013年天津市参保慢性阻塞性肺疾病患者住院费用结构分析[J].中国卫生统计,2017,34(03):370-373.