[1]苏 勇.基于灰色关联与结构变动度对山东省某三甲医院住院次均费用的结构分析[J].医学信息,2021,34(22):17-21.[doi:10.3969/j.issn.1006-1959.2021.22.005]
 SU Yong.Analysis the Structure of the Average Hospitalization Expense Per Time in Tertiary Hospital in Shandong Province Based on Grey Correlation and Structural Change[J].Medical Information,2021,34(22):17-21.[doi:10.3969/j.issn.1006-1959.2021.22.005]
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基于灰色关联与结构变动度对山东省某三甲医院住院次均费用的结构分析()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年22期
页码:
17-21
栏目:
出版日期:
2021-11-15

文章信息/Info

Title:
Analysis the Structure of the Average Hospitalization Expense Per Time in Tertiary Hospital in Shandong Province Based on Grey Correlation and Structural Change
文章编号:
1006-1959(2021)22-0017-05
作者:
苏 勇
(青岛市市立医院质量管理考核部,山东 青岛 266071)
Author(s):
SU Yong
(Quality Management Assessment Unit,Qingdao Municipal Hospital,Qingdao 266071,Shandong,China)
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
Keywords:
Average hospitalization expense per timeGray relevancy analysisDegree of structure variationIncome structure
分类号:
R197.322
DOI:
10.3969/j.issn.1006-1959.2021.22.005
文献标志码:
A
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。
Abstract:
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.

参考文献/References:

[1]新华社.中华人民共和国国民经济和社会发展第十四个五年规划和2035年远景目标纲要[EB/OL].(2021-03-13)[2021-08-03].http://www.gov.cn/xinwen/2021-03/13/content_5592681.htm.[2]孟立联.“十四五”卫生健康发展规划必须直面的问题剖析[J].中国农村卫生事业管理,2020,40(10):689-696.[3]黄冠,龚丽洁,于润吉.控制公立医院医疗费用不合理增长是医改的重要任务[J].中国卫生经济,2016,35(7):64-65.[4]国家卫生计生委.关于印发控制公立医院医疗费用不合理增长的若干意见的通知[EB/OL].(2015-10-27)[2021-08-03].http://www.mohrss.gov.cn/SYrlzyhshbzb/shehuibaozhang/zcwj/yiliao/201512/t20151208_228150.html.[5]国务院办公厅.国务院办公厅关于推动公立医院高质量发展的意见[EB/OL].(2021-6-4)[2021-08-03].http://www.gov.cn/zhengce/content/2021-06/04/content_5615473.htm.[6]中华人民共和国财政部.医院会计制度[M].北京:经济科学出版社,2011.[7]谭学瑞,邓聚龙.灰色关联分析:多因素统计分析新方法[J].统计研究,1995(3):46-48.[8]苏敏,方鹏骞,白雪.基于灰色关联的急性阑尾炎住院费用及影响因素分析[J].中华医院管理杂志,2018,34(12):1022-1025.[9]季小雨,姚育楠,曾智.基于灰色关联度分析方法的江苏省个人卫生支出影响因素研究[J].中国卫生经济,2020,39(11):40-43.[10]闫早红,张勇,朱啟鹏,等.结构变动度视角下ICU患者住院费用变化趋势分析[J].中国病案,2019,20(10):49-52.[11]姚奕婷,张远妮,陈元栋,等.基于结构变动度的广东省公立医院医疗收入分析[J].江苏卫生事业管理,2020,31(12):1622-1627.[12]张姸,江芹,杨兴宇,等.基于结构变动度的三甲医院住院费用变化实证研究[J].中国卫生经济,2019,38(9):69-71.[13]国家卫生健康委员会.2018中国卫生健康统计年鉴[M].北京:中国协和医科大学出版社,2018.[14]郭毅,刘梅,曾佩琴,等.新冠肺炎疫情对医院住院患者就诊情况的影响[J].医学信息,2020,33(22):131-133.[15]中国卫生健康委.关于加快推进新冠病毒核酸检测的实施意见[EB/OL].(2020-06-08)[2021-08-03].http://www.gov.cn/xinwen/2020-06/08/content_5518067.htm.[16]山东省卫生健康委员会.关于做好省属公立医院综合改革启动有关工作的通知[EB/OL].(2016-05-30)[2021-08-03].http://wsjkw.shandong.gov.cn/zwgk/fdzdgknr-/tzwj/201605/t20160530_3444290.html.[17]杨晨,朱宏,邓光璞,等.药品零加成政策对医疗费用的影响——以支气管肺炎为例[J].卫生软科学,2020,34(7):50-54.[18]武雨,陆晨,雷韦,等.新疆某省级三甲公立医院次均住院费用结构变化分析——基于灰色关联度和结构变动度[J].卫生软科学,2020,34(11):54-56.[19]董蓬玉,项锲,肖嵩,等.我国医疗费用现状分析[J].医学与社会,2018,31(12):8-11.[20]庞晓燕,刘俊峰,褚湜婧,等.关于进一步完善公立医院补偿机制的建议[J].中国卫生经济,2018,37(3):18-20.[21]林萍,刘宝.医疗服务价格动态调整机制探讨[J].卫生经济研究,2019,36(8):20-23.

更新日期/Last Update: 1900-01-01