肿瘤专科医院单病种成本影响因素的研究
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摘要
[目的]分析单病种成本影响因素并采取有效方式控制医院成本,减少医疗资源耗费,提高医院经济效益,减轻患者经济负担,为物价部门按病种定价提供合理依据。[方法]收集肿瘤专科医院2014～2017年5578例肺部恶性肿瘤住院患者资料,对患者的性别、年龄、支付方式、治疗方式、是否合并症、住院天数等进行单因素分析,筛选出相关的影响因素,再进行多元线性回归分析。[结果]通过单因素和多元线性回归分析,最终筛选出的影响因素为住院天数、治疗方式、出院情况、入院年份、是否首次入院、支付方式、籍贯和是否有并发症,并得到单病种成本的影响因素和单病种成本测算方程。[结论]以单病种成本的影响因素为切入点,在保证患者疗效的情况下,对单病种成本影响因素采取相应的措施和有效方法,降低患者住院成本;医院还可通过单病种成本回归方程预测入院患者即将消耗的成本。
[Purpose] To analyze the influencing factors of single disease cost. [Methods] Data of5578 patients with lung malignant tumors admitted in a cancer hospital from 2014 to 2017 were collected. The factors influencing the hospital cost including gender,age,payment method,treatment method,complications,hospitalization days were analyzed by univariate and multivariate regression with SPSS19.0 software. [Results] Univariate and multivariate regression analyses showed that hospitalization days,treatment method,discharge status,years of hospitalization,first admission or readmission,payment method,native place,complications were Influencing factors of single disease cost,and an equation for estimating the cost of a single disease was obtained. [Conclusion]The countermeasures targeting the influencing factors of single disease cost can reduce the hospitalization cost for patients and a single disease cost regression equation can predict the upcoming cost of hospitalized patients.
[Purpose] To analyze the influencing factors of single disease cost. [Methods] Data of5578 patients with lung malignant tumors admitted in a cancer hospital from 2014 to 2017 were collected. The factors influencing the hospital cost including gender,age,payment method,treatment method,complications,hospitalization days were analyzed by univariate and multivariate regression with SPSS19.0 software. [Results] Univariate and multivariate regression analyses showed that hospitalization days,treatment method,discharge status,years of hospitalization,first admission or readmission,payment method,native place,complications were Influencing factors of single disease cost,and an equation for estimating the cost of a single disease was obtained. [Conclusion]The countermeasures targeting the influencing factors of single disease cost can reduce the hospitalization cost for patients and a single disease cost regression equation can predict the upcoming cost of hospitalized patients.
引文
[1] Wen H. Cost accounting method and cost study for single disease[D]. Changsha University of Technology,2013.5.[文卉.单病种成本核算方法与费用研究[D].长沙理工大学,2013.5.]
[2] Deng J,Song XG,Xie Y,et al. Cost-benefit analysis of single disease based on historical cost:a case study of benign breast tumors[J]. China Health Economic Research,2018,37(9):50-53.[邓婕,宋喜国,谢郁,等.以历史费用为基础的单病种费用与成本-效益分析:以乳腺良性肿瘤为例[J].中国卫生经济研究,2018,37(9):50-53.]
[3] Gao NN. Study on hospital cost management based on the perspective of visible and hidden[D]. Tianjin University,2015.5.[高妮妮.显性与隐性视角下的医院成本管理研究[D].天津大学,2015.5.]
[4] Mao WM,Xu SH. Lung cancer can be prevented and treated[M].Beijing:People’s Health Publishing House,2015.1.[毛伟敏,许沈华.肺癌可防可治[M].北京:人民卫生出版社,2015.1.]
[5] Li H. Pricing mechanism and method of single disease medical service[D]. Tianjin University,2013.12.[李惠.单病种医疗服务定价机制与方法研究[D].天津大学,2013.12.]
[6] Ministry of Finance of the People’s Republic of China.Hospital accounting system[M]. Beijing:Economic Science Press,2011.52.[中华人民共和国财政部.医院会计制度[M].2011年第1版.北京:经济科学出版社,2011.52.]
[7] Jin LX,Yu LH,Li YC,et al. Discussing the process of disease cost accounting based on cost-cost conversion method[J]. China Health Economy,2017,36(3):87-89.[金丽霞,于丽华,李奕辰,等.基于费用成本转换法的病种成本核算流程探讨[J].中国卫生经济,2017,36(3):87-89.]
[8] Li SM,Huang WH,Chen JY,et al. Implementing the policy of zero price difference for drugs and its impact on the economic operation of specialized hospitals and suggestions[J]. China Health Economy,2016,35(2):23-25.[李淑梅,黄文化,陈锦裕,等.实施药品零差价政策对专科医院经济运营的影响及建议[J].中国卫生经济,2016,35(2):23-25.]
[9] Le X,Liu M,Pu CT,et al. Analysis of the impact of clinical pathway management on hospitalization days and hospitalization expenses[J]. China Medical Records,2017,18(5):31-33.[乐新,刘敏,蒲春涛,等.临床路径管理对住院天数和住院费用的影响分析[J].中国病案,2017,18(5):31-33.]
[10] Jin PM,Hua W,Chen J,et al. Study on the composition and influencing factors of hospitalization ex penses for 10common malignant tumors[J].China Hospital,2016,20(8):44.[金萍妹,华伟,陈洁,等.10种常见恶性肿瘤住院费用构成及影响因素研究[J].中国医院,2016,20(8):44.]
[11] Hu B,Li XY. Comparative analysis of actual cost and standard cost of single disease[J]. Health Economic Research,2019,36(4):37-39.[胡斌,李星仪.单病种实际成本与标准成本对比分析研究[J].卫生经济研究,2019,36(4):37-39.]
[2] Deng J,Song XG,Xie Y,et al. Cost-benefit analysis of single disease based on historical cost:a case study of benign breast tumors[J]. China Health Economic Research,2018,37(9):50-53.[邓婕,宋喜国,谢郁,等.以历史费用为基础的单病种费用与成本-效益分析:以乳腺良性肿瘤为例[J].中国卫生经济研究,2018,37(9):50-53.]
[3] Gao NN. Study on hospital cost management based on the perspective of visible and hidden[D]. Tianjin University,2015.5.[高妮妮.显性与隐性视角下的医院成本管理研究[D].天津大学,2015.5.]
[4] Mao WM,Xu SH. Lung cancer can be prevented and treated[M].Beijing:People’s Health Publishing House,2015.1.[毛伟敏,许沈华.肺癌可防可治[M].北京:人民卫生出版社,2015.1.]
[5] Li H. Pricing mechanism and method of single disease medical service[D]. Tianjin University,2013.12.[李惠.单病种医疗服务定价机制与方法研究[D].天津大学,2013.12.]
[6] Ministry of Finance of the People’s Republic of China.Hospital accounting system[M]. Beijing:Economic Science Press,2011.52.[中华人民共和国财政部.医院会计制度[M].2011年第1版.北京:经济科学出版社,2011.52.]
[7] Jin LX,Yu LH,Li YC,et al. Discussing the process of disease cost accounting based on cost-cost conversion method[J]. China Health Economy,2017,36(3):87-89.[金丽霞,于丽华,李奕辰,等.基于费用成本转换法的病种成本核算流程探讨[J].中国卫生经济,2017,36(3):87-89.]
[8] Li SM,Huang WH,Chen JY,et al. Implementing the policy of zero price difference for drugs and its impact on the economic operation of specialized hospitals and suggestions[J]. China Health Economy,2016,35(2):23-25.[李淑梅,黄文化,陈锦裕,等.实施药品零差价政策对专科医院经济运营的影响及建议[J].中国卫生经济,2016,35(2):23-25.]
[9] Le X,Liu M,Pu CT,et al. Analysis of the impact of clinical pathway management on hospitalization days and hospitalization expenses[J]. China Medical Records,2017,18(5):31-33.[乐新,刘敏,蒲春涛,等.临床路径管理对住院天数和住院费用的影响分析[J].中国病案,2017,18(5):31-33.]
[10] Jin PM,Hua W,Chen J,et al. Study on the composition and influencing factors of hospitalization ex penses for 10common malignant tumors[J].China Hospital,2016,20(8):44.[金萍妹,华伟,陈洁,等.10种常见恶性肿瘤住院费用构成及影响因素研究[J].中国医院,2016,20(8):44.]
[11] Hu B,Li XY. Comparative analysis of actual cost and standard cost of single disease[J]. Health Economic Research,2019,36(4):37-39.[胡斌,李星仪.单病种实际成本与标准成本对比分析研究[J].卫生经济研究,2019,36(4):37-39.]
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