乙型肝炎后肝硬化失代偿期患者次均住院费用新灰色关联与结构变动分析

doi:10.3969/j.issn.1006-5253.2024.02.007

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摘要目的了解某院乙型肝炎后肝硬化失代偿期患者次均住院费用内部构成及变化，为降低患者医疗负担、优化住院费用结构及控制医药费用增长提供参考。方法选取广东省某三级甲等医院2018年1月至2023年8月期间7 459例次乙型肝炎后肝硬化失代偿期患者的住院费用明细，运用新灰色关联与结构变动分析法对患者各细项费用的关联度、变动度及贡献率等指标进行统计分析。结果 2018—2021年该院乙型肝炎后肝硬化失代偿期患者次均住院费用逐年增长，年均增长7.01%；2022年和2023年出现下降，较上年分别下降7.64%和8.04%。次均住院费用构成比前4位是药品费、诊断费、耗材费、治疗费。次均住院费用关联度最大的是药品费（0.915），其次是诊断费（0.909）和耗材费（0.770）。结构贡献率前3位是药品费（43.27%）、诊断费（19.12%）、耗材费（17.91%），3者累计结构变动贡献率超过80%。结论药品费、诊断费和耗材费是影响住院费用的主要因素，是降低患者住院费用的重点；需进一步调整优化住院费用结构，体现医务人员劳动技术价值，降低患者医疗费用负担。

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	邓淑敏
	师雯琦
	李莉莉
	陈晓霞
	刘子锋
	陈静静

关键词 ：住院费用, 新灰色关联, 结构变动度, 乙型肝炎后肝硬化失代偿期

Abstract：Objective To understand the average hospitalization cost structure of patients with hepatitis B cirrhosis at decompensated stage from January, 2018 to August, 2023, so as to provide a reference for reducing the medical burden of patients, optimizing the hospitalization cost structure and controlling the growth of medical costs.Methods The medical costs of 7 459 patients with hepatitis B cirrhosis at decompensated stage in a tertiary hospital in Guangdong Province from a January, 2018 to August, 2023 were selected. Grey correlation and structural variation degree analysis method were used to analyze the correlation degree, variation degree and contribution rate of each item cost of patients.Results The average hospitalization cost of patients with decompensated post-hepatitis B cirrhosis increased year by year from 2018 to 2021, with an average annual growth of 7.01%, and then decreased in 2022 and 2023, with a decline rate of 7.64% and 8.04%, respectively. The top four costs were the drug cost, the diagnosis cost, the consumables cost, and the treatment cost. The drug cost (0.915), the diagnosis cost (0.909) and the consumables cost (0.770) had the highest correlation coefficient. The top three items with the highest structural contribution rate were drug cost (43.27%), diagnostic cost (19.12%), and consumables cost (17.91%), and the cumulative structural change contribution rate of the three was over 80%.Conclusion The drug cost, diagnostic cost and consumables cost were the main factors affecting hospitalization costs, and were the key points to reduce the hospitalization cost of patients. It is necessary to further adjust and optimize the structure of hospitalization costs, reflect the labor and technology value of medical staff, and reduce the burden of patients′ medical expenses.

Key words： hospitalization cost new grey correlation structural variation degree hepatitis B cirrhosis at decompensated stage

收稿日期: 2023-11-28

通讯作者: 陈静静，Email：1026063703@qq.com

引用本文:

邓淑敏，师雯琦，李莉莉，陈晓霞，刘子锋，陈静静. 乙型肝炎后肝硬化失代偿期患者次均住院费用新灰色关联与结构变动分析[J]. 中国医院统计, 2024, 31(2): 113-117.
Deng Shumin，Shi Wenqi，Li Lili，Chen Xiaoxia，Liu Zifeng，Chen Jingjing. New gray correlation and structural variation degree analysis of average hospitalization costs of patients with hepatitis B cirrhosis at decompensated stage. journal1, 2024, 31(2): 113-117.

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［1］王娟,李会师,梁乐,等.慢性乙型肝炎患者发生肝硬化的影响因素分析及预测模型构建［J］.胃肠病学和肝病学杂志,2022,31(7):752-757.DOI: 10.3969/j.issn.1006-5709.2022.07.006.

［2］WANG T Y, RONG X Y, ZHAO C. Circadian rhythms coordinated with gut microbiota partially account for individual differences in hepatitis B-related cirrhosis［J］. Front Cell Infect Microbiol, 2022, 12:936815. DOI: 10.3389/fcimb.2022.936815.

［3］XIAO J, WANG F, WONG N K, et al. Global liver disease burdens and research trends: Analysis from a Chinese perspective［J］. J Hepatol, 2019, 71(1):212-221. DOI: 10.1016/j.jhep.2019.03.004.

［4］孔祥欣,吴文裕.基于马斯洛需求理论的层次护理对慢性乙型肝炎后肝硬化患者情绪调节能力及生活质量的影响［J］.中国医药指南,2023,21(22):139-141.

［5］于晶尧,张志豪,李扬,等.新疆某县级医院次均住院费用的灰色关联分析及趋势预测［J］.中国病案,2023,24(6):76-79.DOI: 10.3969/j.issn.1672-2566.2023.06.027.

［6］岳秋颖,李芬,朱碧帆,等.造口患者次均住院费用构成的灰色关联分析［J］.中国卫生资源,2019,22(3):209-212.DOI: 10.3969/j.issn.1007-953X.2019.03.009.

［7］王军永,刘霞.基于结构变动度与灰色关联分析的某妇幼医院产科人均住院费用分析［J］.中国农村卫生事业管理,2022,42(9):626-631.DOI: 10.19955/j.cnki.1005-5916.2022.09.004.

［8］邵慧丽. 急性心肌梗死DRG住院费用新灰色关联与结构变动分析［J］. 河南医学研究, 2023,32(16):2995-2999.

［9］柏龙,谢秋娟.高血压患者住院费用分析［J］.解放军医院管理杂志,2018,25(9):887-890.DOI: 10.16770/j.cnki.1008-9985.2018.09.029.

［10］王建,褚志杰,逯文巧,等.2016—2021年某医院住院费用结构及变动情况分析［J］.中国医院统计,2022,29(4):275-278.DOI: 10.3969/j.issn.1006-5253.2022.04.008.

［11］张瑞明,杨会志.新冠疫情对血液内科收治住院患者的影响［J］.现代医院,2022(9):1380-1383.

［12］马宗奎,刘明孝,胡靖琛,等.基于新灰色关联与结构变动度的DRG付费改革对冠心病患者次均住院费用影响［J］.中国医院管理,2022,42(8):70-73.

［13］孙秀艳.让患者用上更多平价好药［N］.人民日报,2022-08-12(18).

［14］彭宏宇.抗癌药省级专项集中采购政策前后药品费用结构研究［D］.武汉:武汉大学,2020.

［15］陈林,刘国君,云天侦.海南省某医院六种恶性肿瘤患者住院费用的灰色关联分析［J］.中国病案,2023,24(8):51-53.DOI: 10.3969/j.issn.1672-2566.2023.08.018

［16］张星. 价格、行为与规制:我国药品集中带量采购政策研究［D］. 西安:西北大学, 2022.

［17］关于印发进一步规范医疗行为促进合理医疗检查的指导意见的通知［J］. 中华人民共和国国家卫生健康委员会公报, 2020(12):198-201.

［18］林建潮.基于结构变动度的三级公立医院患者次均住院费用分析［J］.中国医院统计,2023,30(1):55-58.DOI: 10.3969/j.issn.1006-5253.2023.01.011.

［19］马强,张彩凤,李芬,等.江西省某三级甲等医院2型糖尿病患者次均住院费用新灰色关联分析［J］.中国卫生资源,2021,24(2):171-175.DOI: 10.3969/j.issn.1007-953X.2021.02.015.