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糖尿病患者住院费用结构变动及影响因素研究

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目的:通过对糖尿病患者住院费用的变化趋势、内部结构变化及其主要影响因素的分析,为优化糖尿病患者住院费用内部结构、有效控制住院费用支出、减轻患者经济负担,并推进医疗服务价格改革提供实证依据.方法:利用案例医院2017-2021年间13 426名糖尿病住院患者的病案首页数据,运用结构变动度和灰色关联度方法,对糖尿病患者住院费用的结构变化进行分析;利用线性回归和BP神经网络模型,对住院费用的影响因素进行分析.结果:在糖尿病住院患者的住院总费用占比中,药品费用和医技费用位列前两位,且二者占住院总费用的比重较大.结构变动度和灰色关联度结果均显示,药品费用、医技费用是引起住院总费用结构变动、与住院总费用关联度较高的两项因素,二者累积贡献率达到90.50%.通过线性回归和神经网络模型的结果发现,在糖尿病患者住院总费用的影响因素中,住院天数是最主要因素,有无手术/操作和诊断的数量位居第2.结论:糖尿病患者住院总费用的内部构成不合理,药品费用、医技费用占比过高,医疗费用、护理费用能说明医务工作者技术劳动价值的比重很低,住院总费用的内部结构有待进一步完善.住院时间是影响糖尿病患者住院总费用的最主要因素,合理控制住院时间能够有效控制不合理的医疗费用增长,减轻糖尿病患者的经济负担.
Study on the Structural Changes and Influencing Factors of Hospitalization Expenses of Diabetic Patients
Objective:By analyzing the cost change trend,internal structure change and main influencing factors of diabetes inpatients'hospitalization expenses,it provides empirical basis for promoting the reform of medical service prices,optimizing the internal structure of hospitalization expenses,effectively controlling hospitalization expenses,and reducing the economic burden of diabetes inpatients.Methods:Using the first page data of medical records of 13 426 diabetes inpatients in the target hospital from 2017 to 2021,it analyzes the structural change of diabetes inpatients'hospitalization expenses by using structural change degree and grey correlation degree methods,and analyzes the influencing factors of hospitalization expenses by using linear regression and BP neural network model.Results:Drug expenses and medical technology expenses are the top two in the proportion of total hospitalization expenses of discharged patients with diabetes,and they account for a large proportion in the total hospitalization expenses.The results of structural change and grey correlation show that drug expenses and medical technology expenses are these two factors that cause changes in the total hospitalization cost structure and have a high correlation with the total hospitalization cost,with a cumulative contribution rate of 90.50%.According to the results of linear regression and neural network model,the length of stay is the most important factor affecting the total cost of hospitalization of diabetes patients,followed by the number of operations/procedures and diagnoses.Conclusion:The internal composition of hospitalization expenses for diabetes patients is unreasonable.The proportion of drug expenses and medical technology expenses is too high.The proportion of medical and nursing expenses reflecting the technical labor value of medical personnel is relatively low.The structure of medical income needs to be further optimized.The length of stay is the most critical factor affecting the hospitalization expenses of diabetes patients.Reasonable control of the length of stay can effectively control the unreasonable growth of medical expenses and reduce the economic burden of diabetes patients.

diabeteshospitalization expensestructural variabilitygrey correlation degreemultiple linear regressionneural network

闫春秒、孙雷、王晓英、王槐敏、刘晓慧、张维军、田东华

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邯郸市中心医院 河北 邯郸 056008

北京师范大学 北京 100875

糖尿病 住院费用 结构变动度 灰色关联度 多元线性回归 神经网络

国家重点研发计划河北省卫生健康委科研项目河北省卫生健康委科研项目河北省医疗保障研究课题河北省医疗保障研究课题

2018YFB21011002023194920231948JYB23002JYB23064

2024

中国卫生经济
中国卫生经济学会,卫生部卫生经济研究所

中国卫生经济

CSTPCDCHSSCD北大核心
影响因子:1.524
ISSN:1003-0743
年,卷(期):2024.43(3)
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