摘要
目的分析山东省某三甲公立医院住院次均费用结构变化趋势及特征,探讨其主要影响因素。方法收集医院2013年1月1日-2020年12月31日的财务年报,计算住院次均费用,并对其进行相关性分析、灰色关联分析和结构变动度分析,定量评价住院次均费用各项费用的关联程度及结构变动情况。结果2013-2020年住院次均费用逐年增长,年均增长2.98%,其中2019-2020年涨幅最大(9.01%),最小的是2015-2016年,住院次均费用下降2.50%。住院均次费用各项构成中,除药品费、其他费用呈现下降趋势外,其余各费用构成均有不同程度上升。费用占比中最高的项目是药品费,其次依次是材料费、化验费和检查费,四项合计占比达75.77%。住院次均费用及构成与年份相关分析结果显示,住院次均费用与年份呈正相关(r=0.923,P<0.05);住院次均费用各项费用构成中,与年份相关性最高的是手术费(r=0.964,P<0.05),药品费与年份呈负相关(r=-0.929,P<0.05)。灰色关联分析结果显示,2013-2020年每年的住院次均费用中,关联系数最大的为药品费(1.0000),其次为材料费(0.8881)和化验费(0.8557)。2013-2020年住院次均费用总结构变动度为52.54%,年均结构变动度为7.51%,从结构变动方向看,药品费全时段负向变动,且在2015-2017年变动较大,对总体结构度的影响最明显;手术费自2015年呈现正向变动,材料费、治疗费、诊查费基本呈正向变动。2013-2020年药品费、材料费、化验费和手术费是引起住院次均费用结构变动的主要因素,四者累计贡献率达到82.09%,其中药品费的结构变动贡献率最大,高达49.68%。结论取消药品加成政策取得显著效果,药品收入及构成比均呈下降趋势;体现医务人员技术劳务价值的收入有所增长,但增幅不明显;卫生材料收入、检查化验收入增长显著,整体收入结构仍需优化。
Objective To analyze the structural trends and characteristics of the average hospitalization expense per time of a tertiary hospital in Shandong Province,to explore its main influencing factors.Methods The hospital's financial annual report from January 1,2013 to December 31,2020 were collected and calculated the average hospitalization expense.The correlation analysis,gray relevancy analysis and structural variation analysis were used to quantitatively evaluate the correlation degree and structural changes between the factors of the average hospitalization expense.Results The average cost of hospitalization increased year by year from 2013 to 2020,with an average annual growth of 2.98%,while the largest increase(9.01%)was in 2019-2020,and the smallest was in 2015-2016,the average cost of hospitalization decreased by 2.50%.In each composition of the average hospitalization expenses,except for the drug expenses and other expenses,the composition of each cost had increased to varying degrees.The highest cost proportion was drug cost,followed by material cost,test cost and inspection cost,and the four items accounted for 75.77%.The results of correlation analysis between the average hospitalization expenses and the year showed that the average hospitalization expenses were positively correlated with the year(r=0.923,P<0.05);among the average hospitalization expenses,the highest correlation with the year was the operation cost(r=0.964,P<0.05),and the drug cost was negatively correlated with the year(r=-0.929,P<0.05).The results of grey correlation analysis showed that among the annual average hospitalization expenses from 2013 to 2020,the highest correlation coefficient was the drug cost(1.0000),followed by the material cost(0.8881)and the laboratory cost(0.8557).From 2013 to 2020,the total structure change of average hospitalization cost was 52.54%,and the average annual structure change was 7.51%,from the direction of structure change,the drug cost changed negatively throughout the period,and changed greatly in 2015-2017,which had the most obvious impact on the overall structure;the operation cost had shown a positive change since 2015,and the material cost,treatment cost and examination cost had basically shown a positive change.In 2013-2020,drug cost,material cost,laboratory cost and operation cost were the main factors causing the structural change of average hospitalization cost,the cumulative contribution rate of the four factors reached 82.09%,and the contribution rate of drug cost was the largest,reaching 49.68%.Conclusion The effect of canceling drug addition was significant,the drug fee and the proportion of the drug were showing a downward trend.The income reflecting the value of medical personnel technical services had been increased,but the increase was not obvious.The Health material income,inspection and testing income growth significantly,the overall income structure still needs to be optimized.
作者
苏勇
SU Yong(Quality Management Assessment Unit,Qingdao Municipal Hospital,Qingdao 266071,Shandong,China)
出处
《医学信息》
2021年第22期17-21,共5页
Journal of Medical Information
关键词
住院次均费用
灰色关联分析
结构变动度分析
收入结构
Average hospitalization expense per time,Gray relevancy analysis
Degree of structure variation
Income structure
