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目的:由于新型农村合作医疗区外转诊病例的例均费用较高,占用新型农村合作医疗基金比例较大,对于基金造成了较大的压力。通过对武汉市周边8个区2009年1月1日至7月1日的区外转诊的部分病例费用的数据分析,找出区外转诊费用的影响因素,以便为区外转诊费用的控制提供科学依据。方法:卡方检验比较区内就诊和区外转诊费用,秩和比检验比较费用的性别差异,多元逐步回归模型分析费用的相关因素。结果:区外转诊的性别构成比与区内的住院病例的性别构成比差异有极显著的统计学意义(P<0.0001),区外男性所占比例明显高于区内男性所占比例;区外转诊的性别间费用差异也有极显著的统计学意义(P<0.0001),男性明显高于女性费用;多元回归分析显示,住院天数、性别和入院状态是影响住院费用的主要因素。结论:控制总的住院费用要从减少住院天数,控制住院费入手;男性应注重及时就医以免小病转成大病;注重对于循环系统疾病和肿瘤的早发现、早治疗。
OBJECTIVE: As a result of the higher average cost per patient for referral outside the New Rural Cooperative Medical Scheme and the relatively large proportion of new rural cooperative medical fund occupations, there is a great pressure on the fund. Through the analysis of the data of some cases referral costs in 8 districts surrounding Wuhan from January 1 to July 1, 2009, the influencing factors of the referral fees outside the district were found out, so as to provide the referral fees Provide a scientific basis for the control. Methods: The chi-square test was used to compare the gender differences in the costs of referral and out-of-district referral, rank-sum ratio test, and multiple stepwise regression models to analyze the cost-related factors. Results: There was a statistically significant difference in gender composition ratio between outpatient referrals and sex ratio in inpatients in the district (P <0.0001). The proportion of men outside the district was significantly higher than that of men in the district. There was also a statistically significant difference in the cost of referral between sexes (P <0.0001), which was significantly higher in males than in females. Multivariate regression analysis showed that the number of days of hospitalization, sex and hospital admission were the major factors affecting hospitalization costs. Conclusion: To control the total cost of hospitalization, we should start from reducing hospitalization days and controlling hospitalization expenses. Men should pay attention to timely medical treatment so as to avoid the serious illness from minor illness. Pay attention to the early detection and early treatment of circulatory system diseases and tumors.