本文選題：工傷 + 工傷保險　； 參考：《中南大學(xué)》2013年碩士論文

【摘要】：目的：分析2005年-2010年7月間某省省本級工傷醫(yī)療保險參保人員住院費用,探討其影響因素,對該省省本級工傷保險住院總費用進(jìn)行初步預(yù)測,為今后工傷保險制度的進(jìn)一步改革、完善及工傷醫(yī)療費用結(jié)算模式的調(diào)整提供數(shù)據(jù)支持。 方法：數(shù)據(jù)為某省省本級2005-2010年7月工傷保險參保職工且在該期間有出院經(jīng)歷的住院患者,數(shù)據(jù)清理后符合研究要求的參保人員共9294例(人次),構(gòu)成本研究對象。本研究對住院費用構(gòu)成情況進(jìn)行統(tǒng)計分析,并從性別、單位性質(zhì)、醫(yī)院級別、年份、年齡、事故性質(zhì)、住院天數(shù)等方面進(jìn)行人次住院費用單因素分析；以次均住院費用為應(yīng)變量,以性別、單位性質(zhì)、醫(yī)院級別、年份、行業(yè)、工齡、年齡、受傷程度、住院天數(shù)以及事故性質(zhì)分類為自變量進(jìn)行逐步多元線性回歸分析,探討工傷患者次均住院費用主要影響因素；采用灰色預(yù)測模型對住院總費用進(jìn)行初步預(yù)測。研究中所使用的統(tǒng)計分析軟件包括：Excel2007、SPSS13.0和Matlab6.5。 結(jié)果： 1.工傷患者住院費用情況：①2005-2009年間該省省本級工傷患者住院費用逐年遞增,次均費用為1.85萬元；②各部分費用中藥費所占比例最高,占總費用的43%。 2.工傷患者住院費用影響因素分析：①分別對不同性別、不同單位性質(zhì)、不同醫(yī)院級別、不同年份、不同行業(yè)、不同工齡、不同年齡、不同受傷程度、不同事故性質(zhì)、不同住院天數(shù)分組間的工傷住院患者次均總費用、監(jiān)護(hù)費、檢查化驗費、治療費、材料費、藥品費、一般醫(yī)療服務(wù)費進(jìn)行比較,結(jié)果顯示以上10個因素的住院費用差異有統(tǒng)計學(xué)意義(P0.05)；②采用逐步多元線性回歸對住院費用進(jìn)行多因素分析,結(jié)果表明除年齡、單位性質(zhì)、行業(yè)類別外,其余7因個素：住院天數(shù)、醫(yī)院等級、年份、受傷程度、工齡、事故性質(zhì)、性別均是次均住院費用的主要影響因素。住院時間越長,醫(yī)院等級越高、受傷程度越嚴(yán)重、工齡越長、住院費用越高的事故所引起的職業(yè)傷害次均住院費用就越高,女性工傷患者次均住院費用略低于男性,企業(yè)單位工傷職工住院費用高于事業(yè)單位。 3.灰色預(yù)測結(jié)果顯示,該省省本級2010-2012年工傷患者住院費用呈逐年遞增趨勢。 結(jié)論： 1.該省省本級工傷參保人員住院費用逐年增高,藥品費比重最大,說明合理控制藥費是降低工傷患者住院費用的重要方面。 2.住院天數(shù)、醫(yī)院等級、年份、受傷程度、工齡、事故性質(zhì)、性別均是次均住院費用的主要影響因素。 3.該省省本級工傷患者住院費用呈持續(xù)增加趨勢,提示相關(guān)部門應(yīng)探索合適的工傷醫(yī)療費用結(jié)算模式、進(jìn)一步完善工傷保險制度。
[Abstract]:Objective: to analyze the hospitalization expenses of the employees participating in the work-related injury medical insurance in a province from 2005 to July 2010, to explore the influencing factors, and to make a preliminary prediction of the total hospitalization cost of the work-related injury insurance at the provincial level.It provides data support for the further reform of the industrial injury insurance system and the adjustment of the settlement model of the medical expenses of industrial injury.Methods: data were obtained from 9294 inpatients who participated in industrial injury insurance in July 2005-2010 and had discharged from hospital during this period. 9294 insured persons met the requirements of the study after data cleaning (person-time), which constituted the object of this study.In this study, the composition of hospitalization expenses was statistically analyzed, and the single factor analysis was carried out from the aspects of gender, unit nature, hospital grade, year, age, nature of accident, length of stay in hospital and so on.The average hospitalization cost was regarded as dependent variable, sex, unit nature, hospital grade, year, industry, length of service, age, injury degree, length of stay in hospital and nature of accident were classified as independent variables by stepwise multivariate linear regression analysis.To explore the main influencing factors of average hospitalization expenses of work-related injury patients, and to make a preliminary prediction of total hospitalization expenses by using grey prediction model.The statistical analysis software used in the study included:: excel 2007 SPSS 13.0 and Matlab 6.5.Results:1.From 2005 to 2009, the hospitalization expenses of work-related injury patients increased year by year in the province, and the average cost per case was 18500 yuan. The proportion of drug expenses was the highest, accounting for 43% of the total expenses.2.Analysis of the factors affecting the hospitalization expenses of work-related injury patients; different sex, different unit nature, different hospital grade, different year, different profession, different working years, different age, different injury degree, different accident nature,The average total cost, guardianship fee, examination and test fee, treatment fee, material cost, drug fee, general medical service charge of the work-related injury inpatients among different days of hospitalization were compared.The results showed that the difference of hospitalization cost among the above 10 factors was statistically significant. The stepwise multivariate linear regression analysis was used to analyze the hospitalization cost. The results showed that, except for age, unit nature, and industry category,The other 7 factors: hospitalization days, hospital grade, year, degree of injury, length of service, nature of accident, sex were all the main influencing factors of average hospitalization expenses.The longer the hospital stay, the higher the hospital grade, the more serious the injury, the longer the length of service, the higher the hospitalization cost, the higher the average hospitalization cost of the occupational injury caused by the accident, and the lower the average hospitalization cost of the female work-related injury patients is slightly lower than that of the male.The enterprise unit inductrial injury worker hospitalization expense is higher than the institution.3.The grey forecast results show that the hospitalization expenses of the work-related injury patients in this province are increasing year by year in 2010-2012.Conclusion:1.The hospitalization expenses of the employees participating in work-related injuries in the province are increasing year by year, and the proportion of drug fees is the largest, which shows that reasonable control of drug costs is an important aspect of reducing the hospitalization expenses of work-related injury patients.2.Days of hospitalization, hospital grade, year, degree of injury, length of service, nature of accident, sex were all the main factors affecting average hospitalization expenses.3.The hospitalization expenses of the work-related injury patients at the provincial level are increasing continuously, which suggests that the relevant departments should explore the appropriate settlement mode of the medical expenses of industrial injuries and further improve the industrial injury insurance system.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：F842.616

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本文編號：1750438