Analysis on the Influencing Factors of Hospitalization Expenses for Patients with Ischemic Stroke in the Context of DRGs Payment
Objectives To study the changes and influencing factors of hospitalization expenses for ischemic stroke patients before and after the implementation of DRGs payment,thus to provide a basis for controlling medical expenses and improving the refined management ability.Methods The patients with ischemic stroke were hospitalized in a hospital before DRGs payment(2019)and after payment(2022)as the subjects,the basic information and hospitalization costs information of the objects were obtained from the medical information system.The nonparametric rank sum test was used to analyze the changes in hospitalization expenses before and after DRGs payment,and multiple regression analysis was used to explore the influencing factors of average hospitalization expenses for Ischemic stroke patients.Results A total of 9421 ischemic stroke patients were included,5030 before DRGs payment and 4391 after DRGs payment.After the implementation of DRGs payment,the average hospitalization cost,comprehensive medical service fee,treatment cost and drug cost all decreased,and the diagnosis cost increased slightly.The average hospitalization expenses were mainly composed of drug expenses(44.95％)and diagnosis expenses(39.45％).The results of multiple linear regression analysis showed that age,admission mode,length of stay,drug ratio,transfer department,operation/operation,comorbidities/complications were positively correlated with the average hospitalization cost of ischemic stroke patients.Gender,re-hospitalization and DRGs payment were negatively correlated with the average hospitalization cost of ischemic stroke patients.Conclusions After the implementation of DRGs payment,hospitalization expenses had been controlled,but the cost structure still needed to be optimized.Without affecting the quality of medical care,shortening the number of invalid hospitalization days,rational medication,rational examination could effectively control the economic burden of patients with ischemic stroke.
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