[1]卫安乐,冯 文.脑缺血性疾病患者住院费用影响因素分析[J].卫生经济研究,2023,40(12):14-19.
 WEI Anle,FENG Wen.Study on Influencing Factors of Hospitalization Expenses of Patients with Cerebral Ischemic Diseases[J].Journal Press of Health Economics Research,2023,40(12):14-19.
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脑缺血性疾病患者住院费用影响因素分析

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
40
期数:
2023年12期
页码:
14-19
栏目:
疾病经济负担
出版日期:
2023-11-30

文章信息/Info

Title:
Study on Influencing Factors of Hospitalization Expenses of Patients with Cerebral Ischemic Diseases
作者:
卫安乐1冯 文1
1.北京大学公共卫生学院,北京 100191
Author(s):
WEI Anle FENG Wen
School of Public Health, Peking University, Beijing 100191, China
关键词:
脑缺血性疾病住院费用疾病诊断相关分组多水平模型
Keywords:
cerebral ischemic diseases hospital expenses disease diagnosis-related groups multi-level models
分类号:
R19
文献标志码:
A
摘要:
目的:分析脑缺血性疾病患者的住院费用影响因素,为完善地方DRG分组方案提供依据。方法:利用2019—2020年某地级市医保数据,分析4家三级医院和8家二级医院脑缺血性疾病患者的住院费用,采用多水平模型及多重线性回归分析患者住院费用的影响因素。结果:脑缺血性疾病患者住院费用有11.5%、0.8%和10.7%的变异来自医院级别、三级医院、二级医院之间的差异;医院等级、患者的年龄、性别、合并症或并发症严重程度以及住院时间是住院费用的影响因素。结论:各地应基于DRG“同病同价”政策导向,评估不同级别及同一级别医院之间的费用差异,合理设置机构分层及费率标准;同时考虑患者年龄、疾病严重程度及诊疗模式等因素,制定适合的本土化DRG实施方案。
Abstract:
Objective To analyze the hospitalization expenses of patients with cerebral ischemic diseases and related influencing factors, and to provide a reference for improving the local disease diagnosis-related group(DRG) grouping and implementation scheme. Methods Using data from health insurance fund platform in a prefecture-level city from 2019 to 2020, the hospitalization expenses of patients with cerebral ischemic diseases in four tertiary hospitals and eight secondary hospitals were analyzed. Through multi-level models and multiple linear regressions, the influencing factors of patient hospitalization expenses were analyzed. Results The differences between hospital level, tertiary hospital, and secondary hospital accounted for 11.5%, 0.8%, and 10.7% of the variance in hospitalization expenses of patients with cerebral ischemic diseases, respectively. Hospital level, patient age, gender, severity of comorbidities or complications, and length of hospital stay were influencing factors of hospitalization expenses. Conclusion Based on the DRG policy of "equal price for the same disease", the localities should assess the hospitalization expenses differences between different levels and hospitals at the same level, reasonably set institutional stratification and payment standards, and develop a suitable localized DRG implementation plan considering factors such as patient age, disease severity, and diagnosis and treatment patterns.

参考文献/References:

[1] 王陇德.《中国脑卒中防治报告2020》概要[J].中国脑血管病杂志,2022,17(5):272-280.
[2] 和一恒,任贺,贾金忠,等.中医医院缺血性脑卒中患者住院费用影响因素分析[J].中国病案,2018,19(16):27-31.
[3] 万宇,张俊.影响缺血性卒中患者住院总天数及费用的相关因素分析[J].实用医学杂志,2014(9):1420-1423.
[4] 王可,赵华硕,张虹,等.两水平两分类数据的logistic回归模型对比研究[J].中国卫生统计,2014,31(5):856-859.
[5] 王书平,黄二丹.辽宁省不同类型公立医院疑难危重病例收治现状分析[J].中国医院管理,2020,40(6):55-57.
[6] 黄晓亮,胡伟,曾莉,等.广东省基于DRG的大数据分析为精准提升医院综合能力赋能[J].现代医院,2020,20(6):795-799.
[7] 肖晓华,谢欣睿,梁恒斌,等.不同等级医院医疗检查结果互认标准研究[J].中国医院管理,2019,39(5):14-16.
[8] 洪震,曾军,黄茂盛.缺血性和出血性脑卒中的发病率与年龄的关系[J].上海医学,2000(11):663-665.
[9] World Health Organization.China country assessment report on ageing and health[M].World Health Organization,2015.
[10] 路云,颜俊娴,华娟.老年人共病管理的研究现状及经验探究[J].卫生经济研究,2017,36(7):58-61.
[11] 国家卫生健康委员会医政医管局,北京市卫生计生委信息中心.CN-DRG分组方案(2018版)[M].北京: 北京大学医学出版社,2019.
[12] 李秀梅,刘理,胡海源,等.DRG支付下脑卒中患者住院费用控制研究[J].卫生经济研究,2022,39(1):44-47.
[13] 吴玲红,丁丽,丁仁声.基于结构方程模型的脑卒中患者住院费用影响因素分析[J].中国医院统计,2021,28(2):143-148.

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更新日期/Last Update: 2023-11-30