人工全膝关节置换的住院费用调查分析

发布时间：2018-11-07 11:58

【摘要】：目的通过对人工全膝关节置换(TKA)的住院及各项目费用的统计,分析其影响因素,为医保按病种定额支付标准提供依据。方法采用回顾性调查,对2011-2013年本院行人工全膝关节置换术的305例医保患者按年度分三组,分别对住院费及其各项费用情况进行数据整理、比较分析,应用SPSS 17.0统计软件对数据进行处理。结果总费用、材料费、药费、护理/床位费上涨明显,P0.05,差异具有统计学意义;抗菌药、输血费、麻醉费下降明显,P0.05,差异具有统计学意义;医保及个人支付额均随年度增长而增长,但增长幅度个人大于医保;材料费、药费的占比随年度增长而增长。本院假体费(63.22%)、药品费(13.88%)占比高,而手术费(6.91%)、护理/床位费(0.7%)占比低,与积水潭医院(70.8%、9.3%、2.8%、1.2%)相似,但与国外(56%、4%、29%、4%)占比差别较大。结论假体费、药费及其构成比过高是TKA住院费用逐年递增、住院各项费用占比不合理的主要原因,是影响TKA发展、限制国人接受TKA的重要因素。
[Abstract]:Objective to analyze the influencing factors of total knee arthroplasty (TKA) by analyzing the hospitalization and cost of each item in order to provide the basis for medical insurance according to the standard of fixed payment of disease. Methods 305 patients who underwent total knee arthroplasty in our hospital from 2011 to 2013 were divided into three groups by year. SPSS 17.0 statistical software was used to process the data. Results the total cost, material cost, drug cost, nursing / bed fee increased obviously, the difference was statistically significant, the antimicrobial drug, blood transfusion fee, anesthesia fee decreased obviously, the difference was statistically significant. Both health care and personal payments grew with annual growth, but the increase was greater than that of health care; the proportion of materials and medicines increased with annual growth. The cost of prosthesis (63.22%), medicine (13.88%) and operating expenses (6.91%), nursing / bed fee (0.7%) were lower than that of Jishui Tan Hospital (70.8% 9.33.38%), while the cost of operation (6.91%) and the cost of nursing / bed (0.7%) were low. 1.2% is similar, but the proportion is quite different from that of foreign countries (56%). Conclusion the high cost of prosthesis, drug and its composition is the main reason why the cost of hospitalization in TKA is increasing year by year. It is an important factor that affects the development of TKA and limits the acceptance of TKA in Chinese.
【作者单位】：石河子市人民医院;
【基金】：新疆生产建设兵团卫生科技计划项目(编号2012-13)
【分类号】：R687.4;R197.3

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