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目的比较不同付费方式下脑梗死患者住院费用的差别,并进行效率分析,找出差异的原因,提出合理控制住院费用的思路。方法采用回顾性调查法收集某三级甲等医院的出院病人首页中第一诊断为脑梗死的住院病例,采用SAS 9.2和DEAP 2.1软件进行单因素方差分析和χ2检验对患者基本情况和费用进行分析,并用数据包络分析评价住院费用效率,P<0.05为差异有统计学意义。结果除药费和检查化验费外,不同付费方式下患者的一般医疗服务费(F=9.46,P<0.01)、护理费(F=5.74,P=0.0034)、治疗费(F=4.09,P=0.0173)和总费用(F=4.24,P=0.0148)差异均有统计学意义,住院日(F=14.20,P<0.0001)和治疗结果 (χ2=14.804,P=0.022)之间差异均有统计学意义,医疗保险和自费的相对效率优于公费医疗。结论医疗卫生管理部门应从药费、检查化验费、住院天数等方面重点监控住院费用,进一步推广新型农村合作医疗保险,加大对公费医疗的改革制度,减轻脑梗死患者的经济负担。
Objective To compare the differences in hospitalization costs of patients with cerebral infarction under different payment methods and analyze the efficiency, find out the reasons for the differences, and put forward the idea of reasonable control of hospitalization expenses. Methods A retrospective investigation was conducted to collect the first hospitalized cases of cerebral infarction in the first page of discharged patients in a third class Hospitals. The data were analyzed by one-way ANOVA and χ2 using SAS 9.2 and DEAP 2.1 software. Analysis and data envelopment analysis to evaluate the efficiency of hospitalization costs, P <0.05 for the difference was statistically significant. Results The general medical service fee (F = 9.46, P <0.01), nursing cost (F = 5.74, P = 0.0034) and treatment cost (F = 4.09, P = 0.0173) and the total cost (F = 4.24, P = 0.0148), there was significant difference between the hospitalization days (F = 14.20, P <0.0001) and the treatment results (χ2 = 14.804, P = 0.022) Statistical significance, the relative efficiency of medical insurance and self-pay is better than public medical care. Conclusion The medical and health administrative departments should focus on monitoring inpatient expenses in terms of medicine fees, laboratory tests and days of hospitalization, further promote the new-type rural cooperative medical insurance, and increase the reform of public medical care so as to reduce the financial burden on patients with cerebral infarction.