新疆医科大学学报

目的比较新疆某三甲医院2014-2016年住院总费用及均次费用,为控制医疗机构均次住院费用不合理增长提供科学依据。方法从新疆某三甲综合性医院院端HIS系统获取相关数据,采用描述性的方法分析2014-2016年住院总费用增长率及检查费、药品费、检验费、治疗费、材料费和其它费用构成比。运用单因素方差分析2014-2016年不同年份的均次费用。结果本次共调取了102 652例,其中2014年住院患者为32 890例,2015年为33 373例,2016年为36 389例。2014-2016年住院总人数年均增长率为4.87%,住院总费用年均增长率为3.63%,均次费用年均增长率为-1.65%。2014-2016年间的均次费用比较差异有统计学意义(F=909.33,P=0.013)。2014-2016年6类费用构成中,占比前三类的为药品费、检验费和材料费。结论为降低住院患者均次费用,医疗机构应采取措施控制药品费用增长,通过智能监控、完善均费控制及预警、加强收费管理等手段避免医保基金的过度浪费。

Objective To compare the total cost of hospitalization and the average cost of a Top-three hospital in Xinjiang in 2014-2016 to provide a scientific basis for controlling the unreasonable increase of hospitalization expenses in medical institutions.Methods The data were collected from the hospital-based HIS system in a top-three comprehensive hospital in Xinjiang.Descriptive method was used to analyze the total cost of hospitalization for 2014-2016 and the expense ratio of inspections,medicines,measurements,treatments,materials and others and oneway analysis of variance in different years of 2014-2016 was used on the average costs.Results A total of 102 652 patients were enrolled,including 32 890 inpatients in 2014,33 373 in 2015 and 36 389 in 2016.The average annual growth rate of hospitalization in 2014-2016 was 4.87%.The average annual growth rate of total hospitalization expenses was 3.63%.The average annual growth rate of average cost was-1.65%.There was statistical difference in the average cost between 2014 and 2016(F=909.33,P=0.013).Of the six categories of expenses in 2014-2016,the first three categories accounting for the cost were medicines,measurements and materials fees.Conclusion In order to reduce the average cost of hospitalized patients,medical institutions should take measures to control the growth of drug costs,and to avoid excessive waste of medical insurance funds through intelligent monitoring,total cost controlling and early warning,charge managing and other means.