摘要
目的:分析甘肃省某市乙型肝炎(以下简称"乙肝")患者住院费用的构成情况、主要影响因素以及变化趋势,为有效控制乙肝住院费用提供参考.方法:对甘肃省某市2019-2021 年1254 例乙肝患者的住院次均费用进行贴现分析,利用灰色关联分析和结构变动度分析费用构成及变化,用单因素分析和多元逐步回归分析住院费用的影响因素.结果:该市乙肝患者住院次均费用构成中,关联度由高到低依次是西药费、卫生材料费、化验费、检查费、治疗费、中成药费、其他费、护理费、床位费、手术费、中药饮片费.2019-2021 年间,西药费、其他费和卫生材料费的变化对住院费用结构影响最大,结构变动率分别为 29.6%、17.65%、11.70%.影响住院费用的主要因素有性别、医院等级、住院天数、疾病类型、参保类型、是否抗病毒治疗.结论:该市乙肝患者住院费用负担仍然较重,未来需进一步推进DRG支付方式改革、药品集中带量采购、医疗服务价格改革、公立医院薪酬制度改革,探索早诊早治的乙肝患者全病程管理模式.
Abstract
Objective:To analyze the composition,main influencing factors,and trends of hospitalization medical expenses for hepatitis B patients in a city of Gansu Province,providing a reference for effectively controlling these costs.Methods:The aver-age hospitalization cost for 1254 hepatitis B patients from 2019-2021 in a city in Gansu Province was analyzed with discounting,grey relational analysis,and structural change analysis for cost composition.Univariate analysis and multiple stepwise regression were used to identify factors influencing hospitalization costs.Results:The components of hospitalization costs,in decreasing order of correlation,were the costs of western medicine,health materials,laboratory tests,examinations,treatment,Chinese patent med-icine,other costs,nursing care,bed,surgery,and Chinese herbal decoction.From 2019 to 2021,the most significant changes in hospitalization cost structure were in western medicine costs,other costs,and health material costs,with structural change rates of 29.6%,17.65%,and 11.70%,respectively.The primary factors influencing hospitalization costs were gender,hospital grade,length of hospital stay,disease type,insurance type,and antiviral treatment.Conclusion:The burden of hospitalization costs for hepatitis B patients in this city remains substantial.In the future,further reforms are needed in the DRG payment system,central-ized drug procurement,medical service pricing,and public hospital salary systems.Additionally,exploring a comprehensive man-agement model of early diagnosis and treatment for hepatitis B patients is crucial.
维普
万方数据