摘要
目的·了解上海市小儿肺炎住院均次费用的结构变化及相关原因,并提出相应的政策建议。方法·采用新灰色关联分析及结构变动度分析对上海市某儿童专科医院2015-2018年22 543例小儿肺炎患者的住院均次费用进行研究,包括药费、材料费、检查化验费、劳务性费用和床位费共5项均次费用,探讨各均次费用与住院均次费用的关联度及结构变化情况。结果·新灰色关联分析结果显示,各项均次费用的关联度从大到小依次为均次检查化验费(γ3=1.000 0)、均次药费(γ1=0.862 5)、均次床位费(γ5=0.845 1)、均次劳务性费用(γ4=0.796 8)、均次材料费(γ2=0.786 3)。结构变动度分析结果显示,2015-2018年各项均次费用的结构变动贡献率(contribution rate of structure variation,CSV)从大到小依次为均次药费(CSV1=36.22%)、均次床位费(CSV5=27.65%)、均次检查化验费(CSV3=13.91%)、均次材料费(CSV2=13.78%)、均次劳务性费用(CSV4=8.44%),其中均次药费和均次材料费呈负向变动。结论·均次检查化验费和均次药费是影响小儿肺炎住院均次费用的主要因素,均次劳务性费用占比较低。建议进一步调整费用结构,提高劳务收费,优化诊疗流程,控制医疗费用的增长。
Objective·To understand the structural changes and related reasons of the average cost of hospitalization of childhood pneumonia in Shanghai,and to propound related policy suggestion.Methods·New grey correlation and degree of structural variation analysis were used to research the average cost of hospitalization of 22543 children with pneumonia from 2015 to 2018 in a children's specialized hospital in Shanghai.The average cost included 5 categories,i.e.medicine cost,material cost,examination and laboratory cost,labour cost and bed occupation cost.The relational degree and structural changes between each average cost and the average cost of hospitalization were discussed.Results·The new grey correlation analysis showed that the relational degree sort order of each average cost from the highest to the lowest were average examination and laboratory cost(γ3=1.0000),average medicine cost(γ1=0.8625),average bed occupation cost(γ5=0.8451),average labour cost(γ4=0.7968)and average material cost(γ2=0.7863).The degree of structure variation analysis showed that the contribution rate of structure variation(CSV)sort order of each average cost in 2015-2018 from the highest to the lowest were average medicine cost(CSV1=36.22%),average bed occupation cost(CSV5=27.65%),average examination and laboratory cost(CSV3=13.91%),average material cost(CSV2=13.78%)and average labour cost(CSV4=8.44%).The average medicine cost and average material cost were negative variation.Conclusion·The average examination and laboratory cost and average medicine cost are the main factors that influenced the average cost of hospitalization of childhood pneumonia.The proportion of the average labour cost is relatively low.It is suggested that the cost structure like raising labour charges and optimizing diagnosis and treatment process should be further adjusted in order to control the growth of medical costs.
作者
朱伟俊
马进
崔文彬
袁素维
ZHU Wei-jun;MA Jin;CUI Wen-bin;YUAN Su-wei(Shanghai Jiao Tong University School of Public Health,Shanghai 200025,China;Department of Performance Management Office,Children's Hospital of Shanghai Jiao Tong University,Shanghai 200062,China)
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2020年第5期666-670,共5页
Journal of Shanghai Jiao tong University:Medical Science
基金
上海市儿童医院院级课题管理研究专项(ETGL201801)。
关键词
新灰色关联分析
结构变动度
小儿肺炎
住院均次费用
new grey correlation analysis
degree of structure variation(DSV)
childhood pneumonia
average cost of hospitalization
