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目的调查并分析二级医院脑卒中医保住院费用影响因素,探讨控制医保费用不合理增长的方法。方法回顾性分析3 930例脑卒中患者医保住院费用,对患者的一般情况及住院费用构成进行统计描述;采用单因素方差分析、t检验及多元线性回归分析住院费用影响因素。结果脑卒中住院费用中药费占45.78%,检查治疗费占40.79%,单因素分析显示出院转归(F=6.782,P=0.000)、住院日(F=983.866,P=0.000)与住院费用对数差异有统计学意义(P<0.05)。多因素分析显示出院转归(t=7.099,P=0.000)、住院日(t=43.566,P=0.000)与住院费用对数差异有统计学意义(P<0.05)。结论缩短住院日、降低药费、检查治疗费比例,充分发挥社区卫生服务机构的防病和慢病管理作用,降低医保住院费用不合理增长。
Objective To investigate and analyze the influencing factors of hospitalization expenses of stroke insurance in secondary hospitals and explore ways to control the unreasonable increase of medical expenses. Methods A retrospective analysis of 3 930 stroke patients Medicare hospital expenses, the general situation of patients and hospital costs constitute a statistical description; using one-way ANOVA, t test and multiple linear regression analysis of hospitalization costs influencing factors. Results The cost of hospitalization for stroke accounted for 45.78% of the costs of traditional Chinese medicine and 40.79% of the patients were checked for treatment. Univariate analysis showed that hospitalization (F = 6.782, P = 0.000), hospitalization day (F = 983.866, P = 0.000) The difference was statistically significant (P <0.05). Multivariate analysis showed significant differences in logarithm of hospitalization (t = 7.099, P = 0.000) and hospitalization days (t = 43.566, P = 0.000) and hospitalization costs (P <0.05). Conclusions Shorten the hospitalization days, reduce the cost of drugs, check the proportion of the treatment fee, give full play to the community health service agencies for disease prevention and chronic disease management, and reduce the unreasonable increase of hospitalization expenses.