基于结构变动度的道路交通外伤患者住院费用构成分析

目的分析道路交通外伤患者住院费用构成和变化趋势，为降低患者经济负担和优化住院费用结构提供参考。方法收集江苏省某三甲医院2016年-2020年4 374名道路交通外伤住院患者的病案首页，采用结构变动度分析法对各项住院费用进行分析。结果药品费和耗材费是道路交通外伤患者住院费用结构变动的主要因素；体现劳动价值的费用项目占比偏低；住院项目之间存在费用转移现象；人均住院费用增速控制不稳定。结论建议通过完善相应激励机制，健全绩效考核体系和薪酬制度，建立医疗行为监督审查机制，加强医疗行风宣传教育等，将道路交通外伤患者住院费用增长控制在合理范围内。

Analysis of Hospitalization Expenses Composition of Road Traffic Trauma Patients Based on Degree of Structural Variation

ObjectiveTo analyze the composition and change trend of hospitalization expenses of patients with road traffic trauma to provide reference for reducing the economic burden of patients and optimizing the structure of hospitalization expenses.MethodsThe first pages of medical records of 4 374 hospitalized patients with road traffic trauma in a tertiary hospital in Jiangsu Province from 2016 to 2020 were collected, and the hospitalization expenses were analyzed by using the degree of structural variation. ResultsThe cost of drugs and consumables were the main factors for the structural variation of hospitalization expenses of patients with road traffic trauma. The proportion of cost items reflecting labor value was low. There was cost transfer among hospitalization items. The growth rate of hospitalization expenses per capita was under unstable control.Conclusion The increase of hospitalization expenses should be controlled within a reasonable range through effective measures: perfecting the corresponding incentive mechanism; improving the performance appraisal system and salary system; establishing a supervision and review mechanism for medical behavior and strengthening the publicity and education of medical ethics.