摘要
目的 针对海南省结核病患者在诊疗过程中产生的直接医疗费用进行调查研究,分析其影响因素,为减轻患者医疗负担,以及为当地调整医疗保险报销政策提供科学的参考依据。方法 利用海南省2020年卫生总费用核算数据,共包含了14个省级医疗机构,235个市县级医疗机构门诊住院数据资料,其他相关资料来源于海南省2020年统计年鉴、卫生财务年报等,计算海南省该年度结核病患者的直接医疗费用,利用单因素分析和多因素广义线性模型进行探究其影响因素。结果 最终纳入本研究的病例数为11 979例,男性7 526例(62.83%),女性4 453例(37.17%)。患者的直接医疗费用总计为4 320.73万元,其中门诊总费用为273.39万元(6.33%),住院总费用为4 047.34万元(93.67%);费用构成分析中,药品费用为1 790.71万元(41.44%),检查费用为885.47万元(20.49%),其他费用为1644.55万元(38.06%),每例患者直接医疗费用以中位数(四分位数)M(P25,P75)表示为177.50(66.73,764.89)元;多因素广义线性模型分析得出,住院治疗、新农合医保和城镇职工医保是结核病患者直接医疗费用增加的影响因素,直接医疗费用M(P25,P75)分别为:10 425.04(6 560.87,17 374.9)、10 246.5(5 871.28,17 220.33)、3 177.2(293.09,7 730.23)元,OR(95%CI)值分别为:-3.505(-3.499~-3.517)、1.559(1.551~1.569)、2.191(2.188~2.207)。结论 海南省结核病患者的直接医疗费用较高,住院治疗、新农合医保和城镇职工医保是费用增高的影响因素。
Objective To investigate and analyze the factors influencing the direct medical costs of tuberculosis patients in Hainan Province,so as to provide scientific reference for reducing the medical burden of patients and adjusting the medical insurance reimbursement policies in the local area.Methods Using the total health expenditure accounting data of Hainan Province in 2020,including the outpatient and inpatient data of 14 provincial medical institutions,235 city and county level medical institutions,and other relevant data from the 2020 Hainan Statistical Yearbook and Health Financial Yearbook,the direct medical costs of tuberculosis patients in the province in that year were calculated,and the influencing factors were explored using single factor analysis and multivariate generalized linear model.Results The final number of cases included in this study was 11979,including 7526 males(62.83%)and 4453 females(37.17%).The total direct medical costs of patients were 43.2073 million yuan,of which the total outpatient costs were 2.7339 million yuan(6.32%)and the total inpatient costs were 40.4734 million yuan(93.67%).In the cost composition analysis,the drug cost was 17.971 million yuan(41.44%),the examination cost was 8.8547 million yuan(20.49%),other costs were 16.4455 million yuan(38.06%),and the median(quartile)M(P25,P75)direct medical cost of each patient was 177.50(66.73,764.89)yuan.The multivariate generalized linear model analysis showed that hospitalization,new rural cooperative medical insurance(NRCMI)and urban employee medical insurance were the influencing factors of the increase in direct medical costs of tuberculosis patients the median(quartile)M(P25,P75)of direct medical costs are 10425.04(6560.87,17374.9),10246.5(5871.28,17220.33),3177.2(293.09,7730.23)yuan respectively;the OR(95%CI)values were-3.505(-3.499--3.517),1.559(1.551-1.569)and 2.191(2.188-2.207)respectively.Conclusions The direct medical costs of tuberculosis patients in Hainan Province are high.Hospitalization,the new rural cooperative medica
作者
王凡
胡晓洁
苏朱娜
刘春平
WANG Fan;HU Xiao-jie;SU Zhu-na;LIU Chun-ping(Hainan Medical University,Haikou,Hainan 571199,China)
出处
《中国热带医学》
CAS
2023年第5期506-510,共5页
China Tropical Medicine
基金
海南省卫生健康委员会委托课题项目(No.HXK210008)。
关键词
结核病
直接医疗费用
疾病负担
Tuberculosis
direct medical costs
disease burden
