参加医疗保险骨折患者住院费用影响因素分析

目的了解影响参加医疗保险骨折患者住院费用的主要因素，为控制医疗费用的不合理增长和改革医疗保险支付方式提供参考。方法收集济南市某医院2006年9月-2007年4月参加城镇职工医疗保险的113例骨折患者全部住院医疗费用情况，采用线性回归分析可能影响住院费用的因素。结果耗材比例、药费比例、住院天数、是否输血等是影响参加医疗保险的骨折患者住院费用的主要因素。结论合理降低耗材比例和药费比例，缩短住院天数，严格手术与输血适应症是控制骨折住院医疗费用过快增长的关键。应加快和深化医疗保险支付方式的改革，制定科学的骨折诊疗规范、临床路径和费用标准，试行某些病种如骨折等按病种付费结算。

Factors Influencing Hospitalization Expenses in Fracture Patients with Health Insurance

Objective To identify the chief factors influencing the hospitalization expenses in fracture patients with health insurance so as to provide information for the control of irrational increase in medical expenses and reform in the mode of medical insurance payment. Methods A total of 113 fracture patients with medical insurance in a hospital of a certain city from September 2006 to April 2007 were included and statistical analysis was performed by using multinomial linear regression analysis. Results The major factors in uencing the hospitalization expenses in fracture patients with health insurance included the proportion of material fees and drug fees, length of stay, performance of operations and blood transfusion and etc. Conclusion Lowering the proportion of material fees and drug fees reasonably, reducing the length of hospital stay and avoiding operations and blood transfusion were the key to the control of hospitalization expenses for fracture. It is imperative to speed up and deepen the reform in medical insurance system, formulate scientific diagnostic and treatment routines and clinical pathways as well as expense standards, and try out the payment on certain single disease such as fracture.