北京市老年医保患者住院费用及影响因素分析

摘要

Objective To analyze hospitalization expenses and influential factors of elderly inpatients with medical insurance,and to provide scientific evidences for curbing hospitalization expenses and adjusting medical insurance policy.Methods Based on hospitalization data derived from Beijing town during 2007-2011 from 65082 elderly urban inpatients under medical insurance,descriptive analysis and multiple stepwise linear regression methods were used to analyze the hospitalization expense and its influential factors.Results The last 5 year witnessed rising hospitalization expense and average hospitalization expense per admission of elderly patients with medical insurance; among the components of hospitalization expense,cardiovascular/cerebrovascular/tumor/respiratory system diseases cause the heaviest medical burden; days of stay,hospital level,out-of-pocket proportion are the most important influential factors on their hospitalization expense per time.Conclusion The hospitalization expense of elderly patients with medical insurance keeps growing.Therefore,shorter days of stay,rational referral of patients to appropriate hospitals,adjusting out-of-pocket proportion would be effective measures of curbing hospitalization expense.%目的 分析北京市老年医保患者的住院费用及其影响因素,为控制住院费用上涨和调整医疗保险政策提供科学依据.方法 利用2007至2011年北京市城镇65 082例老年医保患者住院资料,采用描述性分析和多元逐步线性回归方法,对其住院费用及影响因素进行分析.结果 5年间,老年医保患者的住院费用和次均住院费用均呈上升趋势；住院费用构成中,心脑血管疾病、肿瘤和呼吸系统疾病造成的医疗负担最重；住院天数、医院等级、自付比例是影响人次住院费用的重要因素.结论 老年医保患者的住院费用仍在不断上涨,合理缩短住院天数、引导患者不同医院之间合理就医、适当调整个人自付比例是控制住院费用的有效手段.