冯俊 李英利 徐婷婷

    [摘要] 目的 了解大型综合医院住院费用结构变动趋势及特征，为控制住院费用不合理增长提供依据。 方法 收集广西某三甲综合医院2014～2016年的住院患者费用资料，运用结构变动值、结构变动度和结构贡献率等指标进行分析。 结果 2014～2016年，三甲医院住院总费用逐年上升，但增速下降，增幅较小。药品费和卫生材料费占住院总费用比例名列前2位。2014～2016年药品费、检查费、诊察费、床位费、治疗费和护理费的结构变动值呈负向变动；化验费、卫生材料费、手术费和其他费用的结构变动值则呈正向变动。药品费和卫生材料费对住院费用变动贡献较大，2项累积贡献率达47.06%。 结论 药费控制政策措施初见成效，但药占比仍较高，还需加强对药品费的管控。住院费用结构不合理，卫生材料费、化验费等比重较高，而体现医护人员技术劳务价值的手术费、护理费等占比较低，费用结构有待调整与优化。

    [关键词] 住院费用；结构变动度；费用控制；大型医院

    [中图分类号] R197.32 [文献标识码] A [文章编号] 1673-7210(2018)05(a)-0147-04

    [Abstract] Objective To analysis the trend and characteristics of hospitalization expenses structure change in a grade Ⅲ level A general hospital， and provide evidence for the unreasonable increase of hospitalization expenses. Methors The hospitalization expenses of patients in a grade Ⅲ level A general hospital from 2014 to 2016 were collected by analyzing the structure changes value， degree of structure variation and structure contribution rate. Results The total hospitalization expenses of the top three hospitals increased year by year from 2014 to 2016， but the growth rate decreased. The proportion of medical expenses and medical materials expenses accounted for the total hospitalization expenses of top 2. The value of negative changes in structure of 2014-2016 medicine fees ......