摘要
目的:分析新农合跨省就医脑梗死患者住院费用影响因素,为有效控制脑梗死患者住院费用提供依据。方法:对新农合跨省就医结算与监管信息系统中2017年的1 138例脑梗死患者的住院数据进行收集,并采用BP神经网络模型分析脑梗死患者各类住院费用的影响因素。结果:在住院总费用构成中,药费、诊断类费用的比重最大,住院天数是总费用及个别分项费用的重要影响因素。结论:在保障医疗质量的前提下,通过实施医药分开与医院财政补助挂钩等方式降低药费,把临床路径管理和DRGs支付方式改革相结合,检验结果互认以降低诊断类费用;同时,设置更为符合分级诊疗政策的新农合跨省就医模式,提高医院信息化管理水平、诊疗水平与管理水平,减少住院天数,以此来缓解新农合跨省就医脑梗死患者的经济负担。
Objective: Analyzing of the influencing factors of Patients with Cerebral Infarction of the trans-provincial treatment of new rural cooperative medical insurance, so as to provide reliable evidence to control the costs of patients with cerebral infarction. Methods: Collecting the hospitalization data of 1 138 patients with cerebral infarction in 2017 from the New Rural Cooperative Medical Information Scheme and analyzing the hospitalization costs influencing factors of patients with cerebral infarction based on BP neural network model. Results: In the hospitalization costs, the costs of medicine and diagnostic occupy a large proportion. The days of hospitalization is an important factor in the total cost and individual item costs. Conclusion: Under the premise of ensuring the quality of medical care, reducing drug costs through the implementation of separate medicines and control of medical expenses and hospital financial subsidies, and combine clinical path management and DRGs payment method reform to reduce diagnostic costs;setting up a new rural cooperative medical system that meets the requirements of grading diagnosis and treatment, implementing the mutual recognition of test results, improving the hospital medical professional level, management level and informatization level, using the classification diagnosis and treatment system to shorten the hospitalization days in large hospitals, minimize the financial burden on patients with cerebral infarction.
作者
陆春吉
李亚子
李国垒
郑见立
刘阳
郭珉江
LU Chun-ji;LI Ya-zi;LI Guo-lei(Medical Information Institute,Chinese Academy of Medical Sciences,Beijing 100020,P.R.C.)
出处
《中国数字医学》
2019年第12期26-29,共4页
China Digital Medicine
基金
科技部重点研发项目-高可信强智能的心脑血管疾病诊疗服务模式解决方案(编号：2017YFC0113000)
院校基础科研业务费项目-基本医保异地就医结报政策及实施效果评估(编号：2017PT63002)~~
关键词
BP神经网络
脑梗死
住院费用
影响因素
敏感度分析
back-propagation neural network
cerebral infarction
hospitalization costs
influencing factors
sensitivity analysis
