基于大数据的基本医疗保险患者住院医疗费用因子分析

摘要

Objective To explore the key factors which control the medical expenses of UEBMI ( Urban Employee Basic Medical Insurance ) inpatients , and provided scientific guidance for controlling medical expenses and medical insurance settlement .Methods Collected the expense data of UEBMI inpatients of ZhanJiang in 2013, used Factor Analysis Method to analyze the data .Results Three factors controlled the medical expenses which named factor of drugs and chemical examination , factor of treat and operation , factor of nursing and test . Conclusions In view of key factors of medical expenses , drug costs and proportion should be concerned for controlling the medical expenses .%目的：探讨支配和影响医疗费用的主要潜在因素，以便合理制订医疗保险结算标准及控制医疗费用。方法以2013年度湛江市三级医院城镇职工基本医疗保险住院患者为样本，采用因子分析方法，对住院患者的医疗费用进行统计分析研究。结果支配基本医疗保险患者住院医疗费用的公因子有三种，分别命名为药物化验因子、手术治疗因子和检查护理因子。结论针对医疗费用的影响因素，积极控制药品费用及药品比例，合理制订基本医疗保险结算标准。