《中国康复理论与实践》

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (12): 1478-1488.doi: 10.3969/j.issn.1006-9771.2025.12.013

• 应用研究 • 上一篇    

2018年至2024年康复科16 827例患者住院费用分析

王丽莎, 袁子文, 蔡昂, 杨博, 姚烨, 闫晓婷, 乔晋()   

  1. 西安交通大学第一附属医院，陕西西安市 710061
  • 收稿日期:2025-01-13 修回日期:2025-10-16 出版日期:2025-12-25 发布日期:2025-12-29
  • 通讯作者: 乔晋 E-mail:qiaojn123@163.com
  • 作者简介:王丽莎(1989-)，女，汉族，陕西西安市人，硕士，主治医师、讲师，主要研究方向：中西医结合康复、肿瘤康复。
  • 基金资助:
    1.陕西省创新能力支撑计划(2022KRM194);2. 陕西省重点研发计划(一般项目)—社会发展领域基金项目(2024SF-YBXM-693)

Hospitalization costs of 16 827 patients in rehabilitation department from 2018 to 2024

WANG Lisha, YUAN Ziwen, CAI Ang, YANG Bo, YAO Ye, YAN Xiaoting, QIAO Jin()   

  1. The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
  • Received:2025-01-13 Revised:2025-10-16 Published:2025-12-25 Online:2025-12-29
  • Contact: QIAO Jin E-mail:qiaojn123@163.com
  • Supported by:
    Shaanxi Provincial Innovation Capacity Support Program(2022KRM194);Shaanxi Provincial Key R&D Program (General Project)-Social Development Fund Project(2024SF-YBXM-693)

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摘要：

目的 探讨康复科从服务付费(FFS)支付方式转变为疾病诊断相关分组(DRG)支付后的费用及结构变化情况。
方法 收集2018年5月至2024年5月西安交通大学第一附属医院康复科患者病案首页信息，共16 827例，分析康复患者住院费用的影响因素。
结果 患者总治疗费占比超过50%，中医治疗和西医治疗费用占比基本持平。中药药品费用占比小幅上升，西药占比逐年下降，总药品(中药加西药)占比从2018年18.2%持续下降至2024年9.2%。在16 827例患者中，并发有高血压的人次最多，占51.94%；功能障碍分类中，运动障碍患者占比最大，占59.14%；病种分类中脑卒中患者人数最多，占49.44%。不同年度下各病种日均住院费用从2023年(实行DRG支付方式)开始明显下降，且2024年最低。不同年度各病种住院人次可见主要病种还是脑卒中，除6大常见病种外的“其他病种”人次逐年递增。影响康复患者康复治疗费的主要因素为住院天数(β = 0.66)和病种(β = -0.43)。
结论 康复科患者住院总费明显下降，中医相关费用占比小幅度增长，总药占比持续下降，康复治疗费用占比稳步保持。DRG支付体系顺利过渡。

关键词: 康复科, 住院费用, 住院天数, 医保支付方式

Abstract:

Objective To explore the changes in expenses and structure after the department's payment method shifting from fee-for-service (FFS) to diagnosis related groups (DRG).
Methods Information from the first pages of medical records of patients in the Rehabilitation Department of the First Affiliated Hospital of Xi'an Jiaotong University from May, 2018 to May, 2024 (n = 16 827) were collected, and then the factors affecting the hospitalization costs of rehabilitation patients were analyzed.
Results The total treatment costs accounted for over 50% of expenditures, with Traditional Chinese Medicine (TCM) and Western medicine treatments contributing nearly equal shares. The proportion of TCM medication costs showed a slight increase, while Western medication costs declined annually. The combined medication costs decreased steadily from 18.2% in 2018 to 9.2% in 2024. Among 16 827 patients, hypertension was the most prevalent comorbidity, affecting 51.94% of cases. Within functional impairment classifications, the patients with motor disorders constituted the largest group at 59.14%. Stroke patients represented the largest disease category, accounting for 49.44% of cases. The average daily hospitalization cost for each disease category showed a significant decline starting in 2023 (when the DRG payment method was implemented), reaching its lowest point in 2024. Across different years, stroke remained the primary diagnosis among inpatient admissions for each disease category. The number of admissions under “other diagnoses” (excluding the six major common diseases) increased annually. The primary factors influencing rehabilitation treatment costs for patients were length of hospital stay (β = 0.66) and disease category (β = -0.43).
Conclusion The total inpatient costs have declined in rehabilitation department from 2018 to 2024, with 2024 marking the lowest level, meanwhile, the proportion of Traditional Chinese Medicine-related costs has slightly increased, and the total drug cost ratio has continued to decrease. The share of rehabilitation treatment expenses has remained stable. This suggests a successful transition to DRG payment system.

Key words: rehabilitation department, inpatient costs, number of days in hospital, medicare payment methods

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