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目的分析心肌梗塞患者住院医疗费用构成及其主要影响因素,提出针对性的对策和措施,为合理控制医疗费用提供参考依据。方法收集天津市2004年1月—2007年12月确诊的心肌梗塞患者共1 602例,分析其费用构成,采用多元线性回归筛选住院费用的影响因素。结果天津市2004—2007年心肌梗塞患者人均住院费用为24 428.82元;心肌梗塞患者药品费、检查费、治疗费、手术费、床位费、医用材料费、输全血费、成分输血费和其他费用分别为5 726.42元(23.44%)、2 279.89元(9.33%)、3 017.60元(12.35%)、396.66元(1.62%)、480.37元(1.97%)、12 389.22元(50.72%)、29.33元(0.12%)、76.32元(0.31%)和33.00元(0.14%);多元线性回归分析结果表明,手术与否、医院等级、人员类别、住院次数、住院天数、年龄是住院费用的影响因素(P<0.05)。结论合理减少心肌梗塞病人的住院天数,控制医用材料、药品费用的不合理增长,是降低心肌梗塞患者住院费用的有效措施。
Objective To analyze the composition of hospitalization expenses and its main influencing factors in patients with myocardial infarction, and to put forward some countermeasures and measures to provide reference for reasonable control of medical expenses. Methods Totally 1 602 cases of patients with myocardial infarction diagnosed in Tianjin from January 2004 to December 2007 were collected. The cost components were analyzed, and the influencing factors of hospitalization expense were screened by multivariate linear regression. Results The per capita hospitalization cost of patients with myocardial infarction in 2004-2007 in Tianjin was 24 428.82 yuan. The costs of medicine, examination, treatment, surgery, bed, medical materials, blood transfusions, blood transfusions and other The expenses were 5,726.42 yuan, 2 279.89 yuan, 9.317%, 3,017.60 yuan, 396.66 yuan, 1.62%, 480.37 yuan, 12389.22 yuan, accounting for 50.72%, 29.33% respectively. (0.12%), 76.32 yuan (0.31%) and 33.00 yuan (0.14%), respectively. The results of multivariate linear regression analysis showed that the factors influencing the hospitalization cost were surgery or not, hospital grade, personnel type, number of hospitalizations, hospitalization days and age (P <0.05). Conclusion It is an effective measure to reduce hospitalization costs in patients with myocardial infarction by reasonably reducing the length of hospital stay, controlling the cost of medical materials and medicines.