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目的通过对2008-2012年度天津市住院患者发生费用超过10万元的病例费用结构的变化趋势及其影响因素的分析,为建立合理的医疗费用控制机制提供参考依据。方法选取2008-2012年度天津市住院费用超过10万元的大额病例为基本资料,计算并分析近5年大额住院病例总费用、总住院天数、人均住院天数、人均住院费用、日均住院费用、药品费所占比例等指标的变化趋势。结果 2008-2012年度天津市大额住院病例人次呈现增长趋势,由2008年的1 103人次增长到2012年3 211人次,费用总额由185 520 286元增长到532 837 354元,药品费所占比例由42.53%下降到38.28%,在所有大额病种中,按病例数的多少,排名前3位的依次有支气管和肺恶性肿瘤、肺炎、白血病。结论为控制日益上涨的医疗费用,应制定合理的措施,同时满足患者大病医疗费用的刚性需求。
OBJECTIVE: To provide a reference for establishing a reasonable medical cost control mechanism by analyzing the changing trend of the cost structure of patients with over 100,000 yuan in hospitalization expenses in Tianjin in 2008-2012 and its influencing factors. Methods Based on the large-scale cases of over 100,000 yuan hospitalization cost in Tianjin from 2008 to 2012 as the basic data, the total cost of hospitalization, total hospitalization days, hospitalization per day, per capita hospitalization cost, average daily hospitalization, Costs, the proportion of drug costs and other indicators of the trend. Results The number of large-scale inpatient cases in Tianjin increased from 1,103 in 2008 to 3,211 in 2012 and the total cost increased from 185,520,286 yuan to 532,837,354 yuan, accounting for the proportion of drug costs From 42.53% down to 38.28%, in all the major diseases, according to the number of cases, the top three followed by bronchial and lung cancer, pneumonia, leukemia. Conclusion In order to control rising medical costs, reasonable measures should be worked out to meet the rigid demand of patients for serious medical expenses.