不同医疗保险付费方式对急性单纯性阑尾炎患者住院费用的影响研究

发布时间：2018-03-10 04:28

本文选题：阑尾炎　切入点：单病种付费　出处：《中国全科医学》2015年13期 　论文类型：期刊论文

【摘要】：目的比较按项目付费(fee-for-service,FFS)和单病种付费两种不同医疗保险付费方式对急性单纯性阑尾炎患者住院费用的影响。方法于2013年2月,采用分层抽样法在长沙市抽取20家医院。在该20家医院中选取符合本研究纳入及排除标准的急性单纯性阑尾炎患者208例。根据医疗保险付费方式,将其分为按项目付费组133例和单病种付费组75例。收集并比较两组患者的临床资料和各项住院费用,包括患者年龄、性别、入住医院等级、医疗结局、平均住院天数、检查费用、麻醉费用、手术费用及药物费用等。结果两组患者性别比较,差异无统计学意义(P0.05);两组患者平均年龄、平均住院天数及入住医院等级比较,差异有统计学意义(P0.05);以术后并发症评价医疗结局,两组患者均无术后并发症发生。两组患者医疗费用、检查费用、手术费用、麻醉费用、药物费用及抗菌药物费用比较,差异有统计学意义(P0.05)。多元线性回归分析显示,医疗保险付费方式、性别、年龄及住院天数对急性单纯性阑尾炎患者抗菌药物费用的影响有统计学意义(P0.05)。结论在不改变医疗结局的基础上,单病种付费组患者的医疗费用、检查费用、手术费用、麻醉费用、药物费用及抗菌药物费用均低于按项目付费组患者。单病种付费方式对急性单纯性阑尾炎患者住院过程中的各项费用有一定控制作用。
[Abstract]:Objective to compare the effects of two different methods of medical insurance payment on hospitalization cost of patients with acute simple appendicitis: fee-for-service FFSs and single-disease payment. Methods in February 2013, patients with acute simple appendicitis were enrolled in this study. The stratified sampling method was used to select 20 hospitals in Changsha City. 208 patients with acute simple appendicitis who met the criteria of inclusion and exclusion of this study were selected from the 20 hospitals. The patients were divided into two groups: 133 patients in the project payment group and 75 patients in the single disease group. The clinical data and hospitalization expenses of the two groups were collected and compared, including age, sex, hospital grade, medical outcome, average days of hospitalization. Results there was no significant difference between the two groups (P 0.05). The difference was statistically significant (P 0.05). There were no postoperative complications in the two groups. The cost of medical treatment, examination, operation, anesthesia, drugs and antimicrobial agents were compared between the two groups. The difference was statistically significant (P 0.05). Multiple linear regression analysis showed that medical insurance payment method, sex, The effect of age and length of stay on the cost of antimicrobial agents in patients with acute simple appendicitis was statistically significant (P 0.05). Conclusion on the basis of no change in the outcome of medical treatment, the cost of medical treatment, the cost of examination, and the cost of operation in patients with single disease paying group were significantly higher than those in control group. The cost of anesthesia, drug and antimicrobial agents were lower than those of the patients who were paid by item. The single disease payment had a certain control effect on the expenses of patients with acute simple appendicitis during hospitalization.
【作者单位】：中南大学护理学院;湖南中医药大学护理学院;湖南省医保局;
【基金】：湖南省长沙市科技局基金资助课题(K1106042-31)
【分类号】：R197.3

【参考文献】