某省工伤保险住院费用影响因素研究

发布时间：2018-04-14 18:10

本文选题：工伤 + 工伤保险　；参考：《中南大学》2013年硕士论文

【摘要】：目的：分析2005年-2010年7月间某省省本级工伤医疗保险参保人员住院费用,探讨其影响因素,对该省省本级工伤保险住院总费用进行初步预测,为今后工伤保险制度的进一步改革、完善及工伤医疗费用结算模式的调整提供数据支持。方法：数据为某省省本级2005-2010年7月工伤保险参保职工且在该期间有出院经历的住院患者,数据清理后符合研究要求的参保人员共9294例(人次),构成本研究对象。本研究对住院费用构成情况进行统计分析,并从性别、单位性质、医院级别、年份、年龄、事故性质、住院天数等方面进行人次住院费用单因素分析；以次均住院费用为应变量,以性别、单位性质、医院级别、年份、行业、工龄、年龄、受伤程度、住院天数以及事故性质分类为自变量进行逐步多元线性回归分析,探讨工伤患者次均住院费用主要影响因素；采用灰色预测模型对住院总费用进行初步预测。研究中所使用的统计分析软件包括：Excel2007、SPSS13.0和Matlab6.5。结果： 1.工伤患者住院费用情况：①2005-2009年间该省省本级工伤患者住院费用逐年递增,次均费用为1.85万元；②各部分费用中药费所占比例最高,占总费用的43%。 2.工伤患者住院费用影响因素分析：①分别对不同性别、不同单位性质、不同医院级别、不同年份、不同行业、不同工龄、不同年龄、不同受伤程度、不同事故性质、不同住院天数分组间的工伤住院患者次均总费用、监护费、检查化验费、治疗费、材料费、药品费、一般医疗服务费进行比较,结果显示以上10个因素的住院费用差异有统计学意义(P0.05)；②采用逐步多元线性回归对住院费用进行多因素分析,结果表明除年龄、单位性质、行业类别外,其余7因个素：住院天数、医院等级、年份、受伤程度、工龄、事故性质、性别均是次均住院费用的主要影响因素。住院时间越长,医院等级越高、受伤程度越严重、工龄越长、住院费用越高的事故所引起的职业伤害次均住院费用就越高,女性工伤患者次均住院费用略低于男性,企业单位工伤职工住院费用高于事业单位。 3.灰色预测结果显示,该省省本级2010-2012年工伤患者住院费用呈逐年递增趋势。结论： 1.该省省本级工伤参保人员住院费用逐年增高,药品费比重最大,说明合理控制药费是降低工伤患者住院费用的重要方面。 2.住院天数、医院等级、年份、受伤程度、工龄、事故性质、性别均是次均住院费用的主要影响因素。 3.该省省本级工伤患者住院费用呈持续增加趋势,提示相关部门应探索合适的工伤医疗费用结算模式、进一步完善工伤保险制度。
[Abstract]:Objective: to analyze the hospitalization expenses of the employees participating in the work-related injury medical insurance in a province from 2005 to July 2010, to explore the influencing factors, and to make a preliminary prediction of the total hospitalization cost of the work-related injury insurance at the provincial level.It provides data support for the further reform of the industrial injury insurance system and the adjustment of the settlement model of the medical expenses of industrial injury.Methods: data were obtained from 9294 inpatients who participated in industrial injury insurance in July 2005-2010 and had discharged from hospital during this period. 9294 insured persons met the requirements of the study after data cleaning (person-time), which constituted the object of this study.In this study, the composition of hospitalization expenses was statistically analyzed, and the single factor analysis was carried out from the aspects of gender, unit nature, hospital grade, year, age, nature of accident, length of stay in hospital and so on.The average hospitalization cost was regarded as dependent variable, sex, unit nature, hospital grade, year, industry, length of service, age, injury degree, length of stay in hospital and nature of accident were classified as independent variables by stepwise multivariate linear regression analysis.To explore the main influencing factors of average hospitalization expenses of work-related injury patients, and to make a preliminary prediction of total hospitalization expenses by using grey prediction model.The statistical analysis software used in the study included:: excel 2007 SPSS 13.0 and Matlab 6.5.Results:1.From 2005 to 2009, the hospitalization expenses of work-related injury patients increased year by year in the province, and the average cost per case was 18500 yuan. The proportion of drug expenses was the highest, accounting for 43% of the total expenses.2.Analysis of the factors affecting the hospitalization expenses of work-related injury patients; different sex, different unit nature, different hospital grade, different year, different profession, different working years, different age, different injury degree, different accident nature,The average total cost, guardianship fee, examination and test fee, treatment fee, material cost, drug fee, general medical service charge of the work-related injury inpatients among different days of hospitalization were compared.The results showed that the difference of hospitalization cost among the above 10 factors was statistically significant. The stepwise multivariate linear regression analysis was used to analyze the hospitalization cost. The results showed that, except for age, unit nature, and industry category,The other 7 factors: hospitalization days, hospital grade, year, degree of injury, length of service, nature of accident, sex were all the main influencing factors of average hospitalization expenses.The longer the hospital stay, the higher the hospital grade, the more serious the injury, the longer the length of service, the higher the hospitalization cost, the higher the average hospitalization cost of the occupational injury caused by the accident, and the lower the average hospitalization cost of the female work-related injury patients is slightly lower than that of the male.The enterprise unit inductrial injury worker hospitalization expense is higher than the institution.3.The grey forecast results show that the hospitalization expenses of the work-related injury patients in this province are increasing year by year in 2010-2012.Conclusion:1.The hospitalization expenses of the employees participating in work-related injuries in the province are increasing year by year, and the proportion of drug fees is the largest, which shows that reasonable control of drug costs is an important aspect of reducing the hospitalization expenses of work-related injury patients.2.Days of hospitalization, hospital grade, year, degree of injury, length of service, nature of accident, sex were all the main factors affecting average hospitalization expenses.3.The hospitalization expenses of the work-related injury patients at the provincial level are increasing continuously, which suggests that the relevant departments should explore the appropriate settlement mode of the medical expenses of industrial injuries and further improve the industrial injury insurance system.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：F842.616

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