新疆某三甲医院常见疾病医保与自费患者住院费用的差异分析

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1、新疆某三甲医院常见疾病医保与自费患者住院费用的差异分析颜涛李中凯于爱平新疆维吾尔自治区人民医院人力资源部新疆维吾尔自治区人民医院北院公室目的分析常见疾病医保和自费患者的住院费用现状及影响因素，为社保机构和医疗机构制定合理有效的费用监管措施提供参考依据。方法资料来自新疆某三甲综合性医院住院2014全年HIS系统中的2型糖尿病、脑梗死、冠状动脉粥样硬化性心脏病、急性化脓性阑尾炎等4种常见疾病,共计2564例。采用非参数检验对医保与自费患者的费用构成对比分析，利用多元线性逐步回归对住院费用影响因素进行分析。结果2型

2、糖尿病的住院费用、住院天数在医保和自费患者间有显著性差异，医保患者的住院费用10975元、住院天数11.2天均高于自费患者7862元、7.5天。急性化脓性阑尾炎的住院费用在医保和自费间经检验有统计学差异，医保患者的住院费用15041元高于自费患者的9108元。脑梗死医保患者的住院天数16.3天，高于自费患者的11.8天卬〈0.05)。4种疾病的费用构成中，药品费所占比重较高，占到了住院费用的30%以上;影响医保和自费患者的住院费用的因素从大到小依次是住院天数、住院次数和年龄。结论医保与自费患者的住院费用存在差

3、异，医保患者比自费患者消耗了更多的医疗资源。通过医疗机构内部费用监控、加强合理用药监管、优化薪酬分配体系，提升医护人员技术价值的方式均可控制住院费用的增长。关键词：医保与自费;住院费用;影响因素;2016-03-29基金：新疆生产建设兵团医疗保险研究会2016年度科技项目(XJBTR-2016YB01)AnalysisonFourKindsofCommonDiseasesHospitalCostsbetweenMedicalInsuranceandSelfFinancedPatientsinaXinjiang

4、TertiaryLevelHospitalYanTaoLiZhongkaiYuAipingHumanResourcesDepartment，ThePeople’sHospitaloftheXinjiangUygurAutonomousRegion;NorthHospital，ThePeople’sHospitaloftheXinjiangUygurAutonomousRegion;Office，ThePeople'sHospitaloftheXinjiangUygurAutonomousRegion;Abst

5、ract：ObjectiveToanalyzetheaffectingfactorsonhospitalizationexpensesformedicareinsuranceandselffinancedpatients,andprovidereferenceforsocialsecurityandmedicalinstitutionstodevelopreasonableandeffectivecostcontrolmeasures.MethodsInformationfromatopthreegenera

6、lhospitalHISsysteminXinjiangfortheyearof2014，Usingnon-parametricteststoanalyzeonhospitalcostsformedicarepatientsattheirownexpense.Multivariatelinearregressionanalysisonfactorsaffectinghospitalizationexpenses.ResultsThehospitalizationexpensesandhospitalizati

7、ondaysoftype2diabetesweresignificantlydifferentbetweenmedicalinsuranceandself-payingpatients.Thehospitalizationcostofmedicalinsurancepatientswas10,775yuan,andthenumberofdaysofhospitalizationwas11.8days.Acutesuppurativeappendicitishospitalizationcostsinhealt

8、hcareandself-financedseethetestwasstatisticallysignificant,medicalinsurancepatientshospitalizationcosts15041yuanhigherthan9108yuanattheirownexpensepatients.Thehospitalstayofpatientswithcerebralinfarcti