康复患者次均住院费用影响因素的分析:基于分位数回归模型OA北大核心CSTPCD

Objective To analyze the distribution and the influcing factors of the average hospitalization costs of rehabilitation inpa-tients of secondary and tertiary hospitals in Gansu Province. Methods The medical records of 6 950 rehabilitation inpatients from January 1st,2017 to June 30th,2023 from 59 sec-ondary and tertiary hospitals in Gansu Province were selected by stratified sampling.The home pages of inpatient medical records were collected through the electronic medical record management system.The distribution and characteristics of the average hospitalization costs of rehabilitation patients were described,and the influencing factors of the average hospitalization costs were analyzed by quantile regression model. Results The average hospitalization cost was 6 282.65(4 095.39,11 829.36)yuan per admission.Multivariate analysis showed that the age(β>21.509),length of stay(β>166.320),hospital level(β>1096.971),hospital category(|β|>969.080),admission pathway(β>307.731),inter-department transference(β>732.289)and medication use(β>737.109)effected the three quantile points(P10,P50,P90)of the average hospitalization costs(P<0.05),the strongest on the highest quantile point.The average hospitalization costs of rehabilitation inpatients admitted from 2017 to 2019 were lower than that admitted from 2020 to 2023 at the 10th quartile point(β=-732.341),but higher at the 90th quartile point(β = 846.445)(P<0.05).Compared with self-payment,the average hospitaliza-tion costs of rehabilitation inpatients paid by medical insurance were higher at the 10th quartile point(βstaff = 450.606,βresident = 478.421),lower at the 90th quartile point(βstaff =-2517.823,βresident =-1283.355)(P<0.05).Compared with other types of diseases,mental and behavioral disorders and neurological diseases cost less(β<-569.500),while circulatory diseases cost more at the 10th quartile point(β = 457.393);and musculoskeletal and connective tissue diseases cost less at the 50th(β =-1106.791)and 90th(β =-3072.947)quartile point(P<0.05). Conclusion The average hospitalization cost varies greatly among different rehabilitation patients,and the influencing factors are complex.Compared with self-payment,medical insurance plays a protective role on the high quantile point of the average hospitalization costs.