7 074例精神疾病患者住院费用影响因素分析

目的了解精神科住院病人医疗费用的影响因素，以控制医疗成本，降低医药费用。方法对2003～2005年出院的7 074例精神疾病患者进行费用构成分析，并对影响医疗费用的因素进行单因素方差分析和多因素逐步回归分析。结果住院费用构成中，药品费比例逐年上升，住院床日费亦呈上升趋势。影响平均床日费的主要因素，按其对床日费作用由大渐小依次为：住院日、出院原因、入院病情、支付方式、年龄和疾病分类。不同支付方式对床日费的影响作用不同。结论建议住院床日费的核定标准应结合住院日核定综合制定。同时，建议利用医院信息系统，对临床药品使用进行实时监控，以及时遏止药品费用的过速增长。

Analysis of factors influencing hospitalization expenses of 7 074 psychiatric inpatients

Objective To understand the factors influencing the hospitalization expenses of psychiatric inpatients with the aim of controlling medical costs and decreasing inpatients' medical expenses by adopting effective countermeasures. Methods The structure of hospitalization expense was analyzed in 7 074 patients with psychiatric diseases who had discharged from hospital during 2003-2005. The methods of one-way analysis of variance and multivariate stepwise regression analysis were used to study the factors influencing hospitalization expenses. Results The structure of hospitalization expense showed that the ratio of drug cost as well as daily expense increased year by year. The major factors influencing the daily expense, ordered by their effects from maximum to minimum,were duration of hospitalization, reason of discharge, disease condition of admission, method of payment, age and classification of disease. Different methods of payment had different effects on daily expense. Conclusion The approved standard of daily expense should be based on the duration of hospitalizatioa Meanwhile, the hospital information system should be used to monitor the clinical use of drugs and control the rapid increase of drug expenses.