摘要
目的分析糖尿病患者住院费用构成及影响因素,为有效控制其医疗费用提供参考。方法收集武冈市农村地区2013—2017年糖尿病患者住院费用数据,采用结构变动度分析、非参数检验及BP(Back Propagation)神经网络模型分析住院费用构成及影响因素。结果糖尿病患者住院费用构成中位于前三位的分别是药费(50.02%)、检查费(15.35%)和化验费(12.06%);住院费用的结构变动贡献率位于前三位的分别是检查费(41.00%)、药费(34.92%)和诊疗费(13.41%);影响糖尿病患者住院总费用的因素包括住院天数、有无手术、医院级别、年龄、出院年份、有无并发症及性别(P<0.05),其中住院天数影响最大(敏感度值为0.669)。结论糖尿病患者住院费用受多种因素的综合影响,建议通过完善医疗服务价格机制优化住院费用构成,并实施临床路径规范管理、落实双向转诊以及加强三级预防等措施控制并合理降低住院费用。
Objective To analyze the composition and influencing factors of hospitalization expenses for diabetic patients,and to provide reference for effective control of medical expenses.Methods The hospitalization cost data of diabetes patients in rural areas of Wugang from 2013 to 2017 were collected.Structural change analysis,non-parametric test and BP(Back Propagation)neural network model were used to analyze the hospitalization expenses and influencing factors.Results The top three components of hospitalization expenses were drug cost(50.02%),examination cost(15.35%)and laboratory cost(12.06%).The contribution rates of structural change of hospitalization expenses were the examination fee(41.00%),drug fee(34.92%)and treatment fee(13.41%),respectively.Factors affecting the total hospitalization cost of diabetic patients included length of stay,operation or not,hospital level,age,discharge year,complication or not and gender(P<0.05),among which length of stay had the greatest impact(sensitivity value was 0.669).Conclusion The hospitalization expenses of patients with diabetes is affected by a variety of factors.It is suggested to optimize the composition of hospitalization expenses by improving the price mechanism of medical services,and to control and reasonably reduce hospitalization expenses by implementing standardized management of clinical pathways,implementing two-way referral and strengthening tertiary prevention.
作者
李冉
韦柳意
毛宗福
LI Ran;WEI Liuyi;MAO Zongfu(School of Health Sciences,Wuhan University,Wuhan 430071,China;Global Health Institute,Wuhan University,Wuhan 430072,China;Health Supervision Institute of Guangxi Zhuang Autonomous Region,Nanning 530021,China)
出处
《公共卫生与预防医学》
2021年第3期20-23,共4页
Journal of Public Health and Preventive Medicine
基金
中组部党建研究会、国家卫健委基层司联合委托重点课题(全党研文〔2017〕3号)。
关键词
糖尿病
住院费用
结构变动度分析
BP神经网络模型
Diabetes
Hospitalization expenses
Structural change analysis
BPneural network model
