摘要
目的分析按单病种限(定)额付费和按项目付费方式下4种疾病的住院总费用及费用结构情况,探讨医疗费用控制方法。方法从武汉市新型农村合作医疗管理系统中抽取2009-2012年4家医院胆囊结石、急性阑尾炎、慢性支气管炎和剖宫产的新型农村合作医疗出院病人费用资料,将资料按照单病种限(定)额付费和按项目付费分为A、B两组,分析比较两组医疗费用情况,主要统计方法为描述性统计和秩和检验。结果 A、B两组4种疾病各自的平均住院总费用和日平均住院费用比较均有统计学差异(P<0.05);胆囊结石、急性阑尾炎和剖宫产的药品费、检查费和手术费组间比较有统计学差异(P<0.05);A、B两组4个病种4年的平均住院费用增幅分别相差0.9%、2.1%、8.6%和0.7%。结论 A组4种疾病的平均住院费用低于B组,且前者各病种平均住院费用的增幅小于后者;有3种疾病的药费占总费用的比例最高,另外手术费和检查费所占比例也较大。
OBJECTIVE It aimed to analyze the hospitalization expenses and its compositions of four different diseases under the single disease payment and fee-for-service payment so as to discuss countermeasures of medical expense control. METHOD From Wuhan NCMS, randomly sampled discharged patients costs data in four hospitals of gall bladder stones, acute appendicitis, chronic bronchitis, cesarean section from 2009 to 2012 and divided the materials into group A and group B, to compare medical expenses of two groups. RESULTS The comparison of average hospitalization expenses and the daily average hospitalization expenses between groups were statistically significant（P〈0.05）; the comparison between groups among medicine, examination and operation expenses of gall bladder stones, acute appendicitis and cesarean delivery was statistically significant（P〈0.05）; the D-value of average hospitalization expense growth rate between two groups from 2009 to 2012 was 0.9%, 2.1%, 8.6% and 0.7% respectively. CONCLUSION The medical costs of A group were lower than B group; in three diseases, the highest proportion of hospitalization expense was medicine, and the cost of laboratory tests and surgery held a high large proportion, too.
出处
《中国初级卫生保健》
2013年第10期20-22,共3页
Chinese Primary Health Care
