[目的]研究医保患者住院费用及个人支付费用的影响因素,探索控制医疗费用的理想方法,为降低医疗费用及个人自付比例提供理论和现实依据。[方法]以河北省3个城市32家医疗机构2004年度所有住院的城镇职工基本医疗保险患者共计1678例为研究对象,采用通径分析方法,对其住院费用及个人支付费用影响因素进行分析。[结果]住院日是影响两费用的最主要影响因素;术前住院天数、癌症、医院等级、其他诊断个数、出院情况、年龄、职业、市别、入院情况、是否手术都对住院费用以及个人支付费用起着直接或间接的作用。[结论]需采取综合措施来有效控制住院费用及个人支付费用的增长。 [Objective] To study the influencing factors of hospitalization expenses and individual payment expenses in Medicare patients and explore the ideal method to control the medical expenses, which provides the theoretical and practical basis for reducing the medical expenses and the proportion of individual payment. [Methods] A total of 1678 patients admitted to urban medical insurance for 32 workers in 32 medical institutions in 3 cities of Hebei Province in 2004 were enrolled in this study. The path analysis method was used to analyze the influencing factors of hospitalization expenses and personal expenses. [Results] The hospitalization days were the most important influencing factors of the two expenses. The length of preoperative hospitalization, cancer, hospital grade, number of other diagnoses, discharge, age, occupation, market, admission and hospitalization were the main factors influencing hospitalization expenses, Personal payment fees play a direct or indirect role. [Conclusion] Comprehensive measures need to be taken to effectively control the growth of hospitalization expenses and personal payment expenses.