摘要
目的了解某三甲医院大于6万元高额住院医疗费用基本特征并进行费用分析,为控制医疗费用的过度增长提供依据。方法选择成都市某三甲医院2005年至2007年出院患者的病历首页,选取总费用在6万元以上的病例808例,对其总费用基本特征和费用等进行统计分析。结果大额住院费用以药费所占比例最大,占38.45%,其次是材料费,治疗费,检查费,放射及放射治疗费,化验费等。不同住院天数的人均费用有显著性统计学差异(P<0.01),住院天数越长,人均总费用越高。随着住院天数的增加,药费、治疗费、放射及放射治疗费在人均总费用的构成中所占比例明显升高,而材料费、手术费所占比例逐渐降低。不同科别的患者,其费用有显著统计学差别(P<0.05),其中最高的是呼吸内科313647元,其次是脑外科2295343元,最低的是脑外科60033元。从付款方式来看,特约患者组仅占19.93%,平均住院天数低于自费组和医保组,但人均费用高于其他2组,差异均具有统计学意义(P<0.05)。治愈及死亡病例住院时间短,费用高。结论高额费用病例的药费比例控制有效,还应减少无效、低效住院时间,控制过度医疗服务,要降低大额医疗费用,必须要加强慢性病的预防与控制,促进社区医疗卫生保健。
Objective We grasped the fundamental characters and the expense analysis of a ＂3 A＂ hospital about it＇s inward expense above 60,000 yuans in order to provide evidence for excessive medical service. Method Selected the first page of the patients who had already dismissed hospital from 2005 to 2007 and select 808 cases whose total inward expense over 60,000 yuans and analyzed it＇s fundamental characters and the total expense. Results The proportion of the drug expenses is the highest （38.45%） and the others are material fee, treatment expense, examination fee, radiation and treatment fee, assay fee. There is significant statistics difference between different inward days （P〈0.01） and the inward days longer ,the mean expense higher. Along with the inward days, the proportion of drug expense, treatment fee, radiation and treatment fee increase, while the material fee and operation fee deerease. There is significant statistics difference of total fee between different inward departments （P〈0.05）.The highest is the Department of Respiratory （313647 yuans） ,the second is the thoracic surgery department （2295343 yuans） and the lowest is the thoracic surgery department （60033 yuans）.According to the mode of payment, the proportion of the special treatment group is 19.93% and it＇s mean inward days is lower than the other groups while it＇s mean inward expense is higher. There is significant statistics difference between the total fees （P〈0.05）.The days of patients who is cured and dying being are shorter and the expense is higher. Conehtsion The control of the proportion of drug fee is effective and we should decrease the expense of excessive medical service and decrease the time of inefficacy or lower effect being in hospital. In order to decrease the expense of mint-for-service, we should control the excessive medical service, enhance the control and prevent of chronic diseases as well.
出处
《医学信息》
2008年第4期495-498,共4页
Journal of Medical Information
关键词
高额住院费用
基本特征
费用控制
High Inward Expense
Fundamental Characters
Expense control
