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目的探讨四川省外科住院病种医疗费用控制情况与对策。方法采用秩和比法对四川省2003年结节性甲状腺肿、急性阑尾炎以及急性胆囊炎等12个外科住院病种的例均费用、药品费用以及药费百分比等指标进行综合评价。结果(1)四川省12个外科住院病种的例均件院费用、药品费用和药品费用百分比3项指标经秩和比综合评价(以RSRc表达),均好于全国资料(P值均＜0．05)。(2)12个外科住院病种费用效益评价(以RSRr表达),四川省为0．5984±0．2162,全国资料为0．4306±0．2614,四川省2003年住院病种费用效益属较好水平(t=5．9472,P =0．0001)．(3)12个外科住院病种中,心肌梗死冠状动脉搭桥术住院医疗费用和平均住院日均高于全国平均水平。结论(1)应加强心肌梗死冠状动脉搭桥术等高新技术项目和急性阑尾炎、腹股沟疝等常见病种住院手术治疗费用控制的研究。(2)应积极探讨适合我国国情的、有效的医疗费用控制措施。
Objective To investigate the status and countermeasures of medical expenses for surgical inpatients in Sichuan Province. Methods The rank-sum ratio method was used to comprehensively evaluate the average costs, drug costs, and percentage of drug costs in 12 surgical inpatients such as nodular goiter, acute appendicitis, and acute cholecystitis in Sichuan Province in 2003. RESULTS: (1) The results of the three cases of hospitalization expenses, medicines, and medicines expenses of 12 surgical inpatients in Sichuan Province were evaluated by the rank sum ratio (expressed by RSRc), which were better than the national data (P values are all < 0.05). (2) Cost-benefit evaluation of 12 surgical inpatients (expressed as RSRr) was 0.5984±0.2162 in Sichuan Province and 0.4306±0.2614 in China. The cost benefit of inpatients in Sichuan Province in 2003 was Good level (t=5.9472, P=0.0001). (3) In 12 surgical inpatients, the cost of hospitalization for coronary artery bypass grafting and average length of stay were higher than the national average. Conclusions (1) High-tech projects such as coronary artery bypass grafting for myocardial infarction and control of hospitalization costs for common diseases such as acute appendicitis and inguinal hernia should be strengthened. (2) It should actively explore effective medical cost control measures that suit China’s national conditions.