摘要
目的了解不同医保类型利福平耐药肺结核患者确诊前和确诊后就医行为和医疗费用情况,为制订政策提供参考依据。方法对2018-2019年佛山市在结核病信息管理系统中登记并且治疗转归结果为“治愈”和“完成疗程”的利福平耐药肺结核患者进行定量问卷调查,了解确诊前后就医行为和医疗费用。结果共纳入调查患者56例,通过因症就诊、年度体检和密切接触者筛查发现患者分别为39例(69.6%)、14例(25.0%)和3例(5.4%)。11例职工医保患者通过年度体检发现4例(36.4%),比例高于其他医保类型患者。49例(87.5%)患者接受过住院治疗,平均住院天数为27d,47例(83.9%)患者门诊治疗时采用自行服药管理。纳入调查患者自初诊至完成治疗人均花费29804元,人均报销7816元(26.2%)。职工医保患者在确诊前、确诊后住院治疗和门诊治疗时报销比例均为最高。结论不同医保肺结核患者在就医行为、治疗管理和直接医疗费用等方面存在差异,应进一步加大力度及早发现耐药肺结核患者,采取措施加强患者服药督导管理,提高医疗保障水平,降低患者经济负担。
Objective To understand the medical seeking behavior and medical expenses of rifampicin-resistant pulmonary tuberculosis patients with different types of medical insurance before and after diagnosis,so as to provide reference for policy-making.Method A quantitative questionnaire survey was conducted among rifampicin resistant pulmonary tuberculosis patients registered in the tuberculosis information management system in Foshan from 2018 to 2019 with the treatment outcome of"cured"and"completed"to understand the medical seeking behavior and medical expenses before and after diagnosis.Result A total of 56 patients were included in the survey.39 patients(69.6%),14 patients(25.0%)and 3 patients(5.4%)were found through symptomatic visits,annual physical examination,and close contact screening respectively.Among 11 employee medical insurance patients,4 cases(36.4%)were found through the annual physical examination,which was higher than that of other medical insurance patients.49 patients(87.5%)had been hospitalized,with an average hospital stay of 27 days.47 patients(83.9%)adopted self-managed medication during outpatient treatment.The average cost of the included patients from first visit to completion of treatment was 29804 yuan,and the average reimbursement was 7816 yuan(26.2%).Employee medical insurance patients have the highest reimbursement ratio before diagnosis and inpatient and outpatient after diagnosis.Conclusion There are differences in medical seeking behavior,treatment management and direct medical expenses among pulmonary tuberculosis patients with different types of medical insurance.We should further strengthen efforts to detect drug-resistant patients as soon as possible,take measures to enhance patient’s medication management,and improve the health security level and reduce patient’s economic burden.
作者
钟倩红
赵之梦
杜芳芳
成诗明
周杰
黄飞
叶一农
张锡林
钟球
Zhong Qianhong;Zhao Zhimeng;Du Fangfang;Cheng Shiming;Zhou Jie;Huang Fei;Ye Yinong;Zhang Xilin;Zhong Qiu(Tuberculosis Control Division,The Fourth People's Hospital of Foshan,Guangdong Foshan 528000;Chinese Anti-tuberculosis Association,Beijing 100710;Department of Chinese Medicine,Foshan Hospital of TCM,Guangdong Foshan 528000;Applied Technology Division,Chinese Center for Disease Control and Prevention,Beijing 102299 China)
出处
《新发传染病电子杂志》
2023年第1期66-70,共5页
Electronic Journal of Emerging Infectious Diseases
基金
佛山市第四医院“登峰计划”高水平医院建设开放基金(FSSYDFKF-2020022)
2020年佛山市自筹经费类科技计划项目(医学类科技攻关)(2020001005597)。
关键词
结核病
利福平耐药
就诊
费用
调查
Tuberculosis
Rifampicin-resistant
Medical seeking
Expense
Investigation
