基于灰色关联和结构变动的广东公立医院住院次均医药费用分析

目的 分析2012—2019年广东省公立医院住院次均医药费用变化趋势,分析探讨影响结构变动的主要因素。方法 用灰色关联分析住院次均医药费用与其各个分项费用之间的关联程度,利用结构变动分析方法描述各个分项费用的变动程度方向和对住院费用影响程度。结果 广东省公立医院住院病人次均医药费用在2012—2019年间呈现逐年增长趋势,年均发展速度4.1%。药品、床位费用占比逐年下降,检查、化验、护理费用占比逐年上升。住院次均医药费用中关联度最大的为检查费用(0.914),其次是治疗费用(0.913)。药品费用在所有时间段均负向变动,检查费用、化验费用、护理费用所有时间段均为正向变动。药品费用的结构贡献率最大(41.473%),其次是卫生材料费(23.135%)。结论 公立医院医疗费用的过快增长得到有效抑制,取消药品加成取得明显成效,医务人员技术劳务价值得到提升,需进一步完善相关政策,优化费用结构。

Average hospitalization expenses of public hospitals in Guangdong Province based on grey correlation and structural variation analysis

Objective To study the main factors influencing the structural change by analyzing the change trend of average hospitalization medical expenses of public hospitals in Guangdong Province from 2012 to 2019. Methods The grey correlation analysis and the structural variation analysis were used to analyze average hospitalization expenses and its sub items. Results From 2012 to 2019, the average medical expenses of inpatients in public hospitals increased year by year, with an average annual growth rate of 4.1%. The proportion of drug fees and bed fees decreased year by year, while the proportion of inspection fees, laboratory test fees, nursing fees increased year by year. The examination fee had the highest relevancy(0.914), followed by the treatment fees(0.913). The drug cost changed negatively in all time periods, while the examination cost, laboratory test cost and nursing cost changed positively. The drug fees contributed mostly to the structural variation(41.473), followed by health materials fees(23.135). Conclusion The excessive growth of medical expenses in public hospitals has been effectively restrained. Remarkable results have been achieved in canceling the drug mark up, and the value of technical services of medical staff has been improved. It is necessary to further improve the relevant policies to optimize cost structure.