摘要
[目的]分析新疆某省级三甲公立医院次均住院费用结构变动趋势及内在驱动力,探讨主要影响因素,为针对性优化住院费用结构及科学控费提供实证依据。[方法]利用灰色关联法、结构变动度评价2014-2018年次均住院各项费用的关联程度及结构变动情况。[结果]2014-2018年,药品费与次均住院费用的关联程度最高(0.943),且对次均费用结构变动度贡献率最高(43.75%);住院次均费用总结构变动度为27.11%,年均变动度为5.42%;药品费、检查费全时段均为负向大幅度变动,化验费和材料费基本为呈正向变动;药品费在4个年度区间结构变动度贡献率超过30%,是贡献率最大的项目。[结论]住院费用的增长仍存在结构性不合理,以物力费用为主导,但反映医护人员知识、技术性服务费用有所增长,住院费用结构趋向合理。建议进一步优化住院费用结构,同步制度设计协同控费方案,规范诊疗行为、建立合理有效的控费机制。
Objective To analyze structure change trend and inherent driving force of per average hospitalization expense in provincial public top tertiary hospital in Xinjiang,explore main influencing factors so as to provide empirical basis for targeted optimizing the structure of hospitalization expenses and scientific cost control.Methods The grey correlation ana1ysis method and structural change degree were used to evaluate the association degree and structural changes degree of per average hospitalization expense from 2014 to 2018.Results The correlation degree between drug costs and per average hospitalization expense was the highest(0.943),and the contribution rate to per average hospitalization expense structure change was the highest(43.75%).Total structure change degree of per average hospitalization expense was 27.11%,annual average change degree was 5.42%.Drug and examination fee were all in negative change by a large margin all time,test and materials costs basically showed positive change.The contribution rate of structure change degree on drug cost in 4 years range was over 30%which was the biggest item.Conclusions The increase of hospitalization costs is still structurally unreasonable and is dominated by material costs,but it reflects the increase in the knowledge and technical service costs of medical staff,and the structure of hospitalization costs tends to be reasonable.It is suggested to further optimize the structure of hospitalization fees,design a coordinated fee control scheme in a synchronized system,standardize the diagnosis and treatment behavior,and establish a reasonable and effective fee control mechanism.
作者
武雨
陆晨
雷韦
路阳
WU Yu;LU Chen;LEI Wei;LU Yang(People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi Xinjiang 830001,China)
出处
《卫生软科学》
2020年第11期54-56,61,共4页
Soft Science of Health
基金
新疆维吾尔自治区卫生健康委青年科技人才科研项目-基于结构变动度的住院费用结构优化研究(WJWY-201821)。
关键词
住院费用
灰色关联
结构变动度
新疆
hospitalization expense
Grey correlation
the degree of structure variation
Xinjiang
