目的: 以精神分裂症为例,探究精神疾病患者住院床日费用的影响因素,为控制医疗费用不合理增长和提升医疗质量提供参考,并为在精神机构实施床日付费方式的探索提供理论依据。方法: 利用单因素分析和多元线性回归分析,收集上海市职工医保精神分裂症患者2021年医保结算数据进行分析。结果: 共纳入11774例患者信息,住院床日费用中位数为403.93元。纳入分析的患者年龄、性别、机构等级、机构性质、是否有合并症、有无手术、住院天数、疾病类型等因素均对住院床日费用有显著影响。结论: 精神疾病患者住院床日费用受多种因素影响,在制定精神疾病医保支付方式时需考虑多种因素,才能达到控制医疗费用不合理增长和提质增效的目的。

Objective: Taking schizophrenia as an example, the paper explores the influencing factors of inpatient bed-day based expenses in patients with mental disorders to provide the reference for controlling irrational increase of medical expenses and improving medical quality, and to provide theoretical basis for the implementation of bed-day based payment methods in mental institutions. Methods: Single factor analysis and multiple linear regression analysis were used to collect medical insurance settlement data of Shanghai employee medical insurance patients with schizophrenia in 2021 for analysis. Results: A total of 11774 patients' information was included, with a median inpatient bed-day based expenses of 403.93 yuan. The age, gender, institutional level, institutional nature, presence or absence of comorbidities, presence or absence of surgery, length of hospital stay, and disease type of the included patients have significant impact on inpatient bed-day based expenses. Conclusion: The inpatient bed-day based expenses of patients with mental illness are affected by multiple factors. When formulating the payment method for medical insurance of mental illness, multiple factors need to be considered in order to achieve the goals of cost control, quality improvement, and efficiency enhancement.