摘要
目的 分析浙江金华广福肿瘤医院疾病诊断相关分组(diagnosis-related groups, DRGs)病组点数付费下慢性阻塞性肺疾病(简称慢阻肺)住院患者医疗费用的影响因素,为降低该病住院患者医疗费用提供参考,为医院病组成本控制提供定量依据。方法 采用回顾性分析方法,收集浙江金华广福肿瘤医院2020年1月1日至2020年12月31日诊断为慢阻肺的1 039例患者资料,包含医疗费用、性别、住院天数、合并症、病情危重等。对因变量进行分组后,先进行单因素分析,后采用Logistic回归进行多因素分析,以确定影响慢阻肺住院患者医疗费用高低的因素。结果 Logistic回归模型结果显示,肺真菌感染[比值比(odds ratio,OR)=60.777]、病情危重(OR=10.497)、住院天数(OR=1.950)是慢阻肺住院患者医疗费用高低的影响因素。结论 肺真菌感染、病情危重、住院天数是影响慢阻肺住院患者医疗费用增高的主要因素。应当规范诊疗,降低平均住院天数,建立慢阻肺患者全生命周期管理,做好疾病早期预防,以降低患者家庭和社会的经济负担。
Objective To analysis of the factors affecting the expenses of inpatients with chronic obstructive pulmonary disease under the payment of disease group points of disease diagnosis related groups(DRGs) in Jinhua Guangfu Oncology Hospital, so as to provide reference suggestions for reducing the hospitalization cost of patients with chronic obstructive pulmonary disease, and provide quantitative basis for the cost control of hospital disease group. Methods Retrospective analysis was used to collect the data of 1 039 patients with COPD diagnosed in Jinhua Guangfu Oncology Hospital from January 1, 2020 to December 31, 2020, including medical expenses, gender, length of stay, complications, critical condition, etc. After grouping the dependent variables, univariate analysis was performed first, and then logistic regression was used for multivariate analysis to determine the influencing factors on the medical expenses of hospitalized patients with chronic obstructive pulmonary disease. Results Logistic regression model showed that pulmonary fungal infection(OR=60.777), critical condition(OR=10.497) and length of hospital stay(OR=1.950) were the influencing factors of hospitalization expenses of COPD. Conclusions Pulmonary fungal infection, critical illness and length of hospital stay are the main factors affecting the increase of hospitalization expenses in patients with chronic obstructive pulmonary disease. It is suggested that the diagnosis and treatment should be standardized, the average length of hospital stay should be reduced, the whole life cycle management of patients with chronic obstructive pulmonary disease should be established, and the early prevention of disease should be done to reduce the burden of family and social economy.
作者
宋莹莹
傅聪
SONG Yingying;FU Cong(Medical Record Room of Jinhua Guangfu Oncology Hospital in Zhejiang Province,Jinhua 321000,China;Information Department,Jinhua Comprehensive Health Security Center in Zhejiang Province,Jinhua 321000,China)
出处
《浙江医学教育》
2022年第6期380-384,共5页
Zhejiang Medical Education
基金
浙江省金华市科技局公益类项目:“基于DRG与疾病风险调整的病种成本管理研究”(2020-4-078)。
关键词
慢性阻塞性肺疾病
住院费用
影响因素
相关分析
Chronic obstructive pulmonary disease
Hospitalization expenses
Influencing factors
Correlation analysis
