摘要
目的探讨医耗联动综合改革对某三甲医院肺癌胸腔镜手术患者住院费用结构的影响。方法选取医耗联动综合改革前后,2017年1月1日-2021年12月31日期间某三甲医院肺癌行胸腔镜手术出院的患者,采用灰色关联和结构变动度的方法分析医耗联动改革前后肺癌胸腔镜手术患者各项费用的结构变动情况。结果肺癌胸腔镜手术患者次均住院费用整体呈增长趋势。与肺癌胸腔镜手术患者住院费用关联度最高的是材料费,关联度为1.0000,其次是手术费和病理费,关联度分别为0.6270和0.6073。住院费用结构变动度为36.11%,其中2018年-2019年的结构变动度最大,为16.50%;从结构变动的方向来看,手术费的结构变动值一直呈现正向变动,其中2018年-2019年变动较大;床位费、诊疗费、药品费和放射费的结构变动值一直呈现负向变动,其中药品费变动最大。手术费对住院费用结构变动贡献率最大,为37.30%,其次是材料费,为13.08%。结论医耗联动综合改革之后,肺癌胸腔镜手术患者的各项费用变化基本符合改革预期,手术费用增加较明显,体现了医务人员的劳动价值,且住院费用结构得到了一定的优化,而医用耗材费用下降并不明显,仍需进一步加强医用耗材的管理。
Objectives This study aims to explore the impact of the comprehensive reform of medical consumption linkage on the structure of hospitalization expenses for lung cancer patients undergoing thoracoscopic surgery in a tertiary hospital.Methods Patients who underwent thoracoscopic surgery for lung cancer in a tertiary hospital from January 1,2017 to December 31,2021 before and after the medical expenditure linkage comprehensive reform were selected as the research objects.The method of gray correlation and structural change degree was used to analyze the structural change of various expenses of lung cancer patients undergoing thoracoscopic surgery before and after the reform of medical consumption linkage.Results The average hospitalization expenses of lung cancer patients undergoing thoracoscopic surgery showed an overall increasing trend.The highest correlation degree with the hospitalization expenses of lung cancer patients undergoing thoracoscopic surgery was the material fee,with a correlation degree of 1.0000,followed by the operation fee and pathology fee,with a correlation degree of 0.6270 and 0.6073,respectively.The degree of change in the structure of hospitalization expenses was 36.11%,of which the structure change degree in 2018-2019 was the largest at 16.50%.From the perspective of the direction of structural changes,the structural change value of surgical fees had been showing positive changes,and the changes in 2018-2019 were relatively large.The structural change values of bed charges,diagnosis and treatment charges,drug charges,and radiation charges had always shown negative changes,among which the changes in drug charges were the largest.Surgical expenses contributed the most to the structure of hospitalization expenses,accounting for 37.30%,followed by material expenses,accounting for 13.08%.Conclusions After the comprehensive reform of medical consumption linkage,the changes in various expenses of lung cancer patients undergoing thoracoscopic surgery basically meet the requirements of this medical consumption linkage comprehensive reform.Surgical costs increased significantly.It reflects the labor value of medical staff.The structure of hospitalization expenses has been optimized to a certain extent,while the cost of medical consumables has not decreased significantly.The management of medical consumables still needs to be further strengthened.
作者
王文娇
贾琎蕊
Wang Wenjiao;Jia Jinrui(Department of Thoracic Surgery,Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China;不详)
出处
《中国病案》
2023年第5期81-84,共4页
Chinese Medical Record
关键词
灰色关联
结构变动度
医疗改革
住院费用
Grey correlation method
Degree of structural change
Medical reform
Hospitalization expenses
作者简介
通信作者:贾琎蕊。
