[1]褚 琦,吴尔律,谢金亮,等.DRG支付下三甲医院大额住院费用病例分析[J].卫生经济研究,2022,39(10):62-64,69.
　CHU Qi,WU Erlyu,XIE Jinliang,et al.Case Analysis of Large Inpatient Expenses in Tertiary Hospitals in the Context of DRG[J].Journal Press of Health Economics Research,2022,39(10):62-64,69.
点击复制

DRG支付下三甲医院大额住院费用病例分析

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
39
期数:
2022年10期
页码:
62-64,69
栏目:
疾病经济负担
出版日期:
2022-09-26

文章信息/Info

Title:
Case Analysis of Large Inpatient Expenses in Tertiary Hospitals in the Context of DRG
作者:
褚 琦1; 吴尔律1; 谢金亮2; 丘雄江1; 陈凤磊1
1.广西医科大学第一附属医院，广西 南宁 530021
2.南方医科大学南方医院，广东 广州 510515
Author(s):
CHU Qi;  WU Erlyu;  XIE Jinliang;  QIU Xiongjiang;  CHEN Fenglei
The First Affiliated Hospital of Guangxi Medical University, Nanning Guangxi 530021, China
关键词:
大额住院费用; 影响因素; 结构方程模型
Keywords:
high inpatient expense;  influencing factor;  structural equation model
分类号:
R19
文献标志码:
A
摘要:
目的：分析大额住院费用病例的特征及费用影响因素。方法：根据5 497例大额住院费用病例数据，运用单因素分析法分析各因素对大额住院费用的影响，并使用结构方程模型进行验证。结果：大额住院费用病例的例均费用为14.03万元（约为普通病例的8.5倍），平均DRG权重为8.10（是普通病例的4.26倍）；病例的性别、年龄、住院天数、科室类别及主诊断大类分组对其住院费用有显著影响。结构方程模型验证结果显示，DRG权重对费用的直接路径影响较小，住院天数是大额住院费用的最大影响因素，其他因素对住院费用的影响很小。结论：建立基于临床路径的DRG病种管理模式，缩短平均住院日，合理降低药品和耗材费用占比，对异常病例进行专项剖析、重点监控，从而实现精准控费。
Abstract:
Objective To analyze the characteristics and influencing factors of large inpatient expenses cases. Methods According to the data of 5 497 cases of large inpatient expenses, the influence of various factors on large inpatient expenses was analyzed by univariate analysis, and the structural equation model was used to verify these influences. Results The average cost of large inpatient cases was 140,300 yuan (about 8.5 times that of ordinary cases), and the average DRG weight was 8.10 (4.26 times that of ordinary cases). Gender, age, length of hospital stay, department category and main diagnosis category grouping of cases had a significant impact on their inpatient costs. Structural equation model showed that DRG weights had little effect on the direct path of costs, while days of hospital stay was the most influential factor in large inpatient costs. And other factors had little impact on hospitalization costs. Conclusion It is suggested to establish a DRG disease management model based on clinical pathways, shorten the average hospital stay, reasonably reduce the proportion of drug and consumable costs, conduct special analysis and focus monitoring on abnormal cases, so as to realize precise cost control.

参考文献/References:

[1] 邓蓬华，杜蕾蕾，厉旦，等.陕西省某三甲医院高额住院费用分析[J].卫生经济研究，2016（10）：43-46.
[2] 马莉，达振强，祝意，等.某三甲医院大额病例住院费用的影响因素分析及结构方程模型验证[J].中国卫生统计，2020，37（1）：3.
[3] 徐勇勇，孙振球，颜虹.医学统计学（第三版）[M].北京：高等教育出版社，2014.
[4] 李梦滢，孙志成，唐尧，等.基于DRG的公立医院临床路径管理体系建设[J].卫生经济研究，2022，39（2）：67-69，74.
[5] 冉拓耀，孙利华.某大型三甲医院住院疾病直接医疗费用及费用构成研究[J].中国病案，2019，20（12）：5.
[6] 吴锁薇，潘琦，陈彤，等. 1282例高额住院患者次均费用影响因素分析[J].中华医院管理杂志，2016，32（11）：4.
[7] 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.
[8] 陆玉军.基于按病种付费的住院费用控制策略研究[J].经济研究导刊，2020，16（31）：90-91，111.

相似文献/References:

[1]邓蓬华,杜蕾蕾,厉 旦,等.陕西省某三甲医院高额住院费用分析[J].卫生经济研究,2016,(10):43.
[2]杨付英,郝晓宁,薄 涛,等.我国老年人失能现状及其影响因素分析[J].卫生经济研究,2016,(11):7.
[3]谭华伟,张 云,郑万会,等.重庆市县级公立医院债务规模扩张及其影响因素分析[J].卫生经济研究,2016,(11):16.
[4]魏 宁,周绿林,张 磊.中老年人口去世前一年医疗费用支出影响因素研究[J].卫生经济研究,2017,(06):27.
[5]张春瑜,王燕森,张何明.医护人员满意度影响因素分析[J].卫生经济研究,2017,(06):61.
[6]张培林,谭华伟,刘 宪,等.县级公立医院薪酬特征及影响因素分析[J].卫生经济研究,2017,(12):9.
[7]李长乐,孙 静,齐小龙,等.我国居民住院服务利用的影响因素分析[J].卫生经济研究,2018,(02):54.
[8]王红波,孙向谦.农村居民参加商业医疗保险的影响因素分析——基于CGSS(2013)的实证分析[J].卫生经济研究,2018,(08):15.
　WANG Hong-bo,SUN Xiang-qian.Analysis of Influencing Factors of Rural Residents' Participation in Commercial Medical Insurance——An empirical analysis based on CGSS (2013)[J].Journal Press of Health Economics Research,2018,(10):15.
[9]陶婉菊,吕轶娟,梁启君,等.贵州省肺癌非手术患者住院费用关联度分析[J].卫生经济研究,2019,(06):35.
　TAO Wan-ju,LV Yi-juan,LIANG Qi-jun,et al.Correlation Analysis of hospitalization Expenses for Non-surgical Patients with Lung Cancer in Guizhou Province[J].Journal Press of Health Economics Research,2019,(10):35.
[10]张 琪,王德永.医疗服务满意度影响因素实证研究[J].卫生经济研究,2019,(07):63.
　ZHANG Qi,WANG De-yong.Empirical Study on the Influencing Factors of Medical Service Satisfaction[J].Journal Press of Health Economics Research,2019,(10):63.

更新日期/Last Update: 2022-09-26