Background： Investigate into the medical expenditures of chronic kidney disease （CKD） patients through path analysis method of three consecutive years within a Grade-A tertiary hospital in Beijing to conduct the ma...Background： Investigate into the medical expenditures of chronic kidney disease （CKD） patients through path analysis method of three consecutive years within a Grade-A tertiary hospital in Beijing to conduct the main influencing factors in diagnosis-related groups （DRGs） grouping of the diagnosis, and reassess the present grouping process to provide information and reference on cost control for hospitals and medical management departments. Methods： Eight hundred and fifty-five inpatient cases whose first diagnosis were defined as CKD in the year 2014-2016 within the hospital were selected as the sample of the study, multiple linear regression and path analysis method were adopted in DRGs grouping process to investigate the main influencing factors of total medical expenditures and DRGs grouping process. Results： The maximum proportion of the medical costs within CKD patients was the costs on treatment, with the highest of 35.3% on the year 2014, the second was the costs on drug, which accounted for 〈30% during consecutive years, and the third was the costs on examination, which accounted for about 20% on average. The main influencing factors of medical expenditures included the type of dialysis, length of hospitalization, the admission of Intensive Care Unit （ICU）, and so on. The coefficients toward the effect for total costs were 0.416, 0.376, and 0.094. respectively. Conclusions： It is suggested that the type of dialysis and the admission of ICU were the major influencing factors of inpatient medical expenditures on CKD patients, and should be taken into consideration into the reassessment of DRGs grouping process to realize the localization and generalization of prospective payment system based on DRGs within the regional area and promote the implementation of medical cost control measures to reduce the economic burdens among patients and the society.展开更多
<strong>Background:</strong> Despite having one of the most successful health systems in the world, annual medical expenditures in Japan have been increasing year to year. We sought to clarify regional dif...<strong>Background:</strong> Despite having one of the most successful health systems in the world, annual medical expenditures in Japan have been increasing year to year. We sought to clarify regional differences in medical expenditures by analyzing the relationship between the specific health examination coverage and medical care expenditure by prefecture of Japan. <strong>Methods:</strong> We used data from the National Database of Health Insurance Claims and Specific Health Checkups (NDB) Open Data Japan (2015) and Overview of 2015 National Medical Expenses to compare medical care expenditure per capita and proportions of persons receiving specific health examination between Japan nationally and individual prefectures. <strong>Results: </strong>National medical expenditures were 42.3 trillion Japanese yen (JPY) (3851 hundred million dollars), with a national per capita rate of JPY347,219 (USD3156). Per capita medical expenditure rates by prefecture ranged from JPY290,900 (USD2645) in Saitama Prefecture to JPY 444,000 (USD4036) in Kochi Prefecture. The proportion of persons receiving specific health examinations was 49.0% for Japan overall and ranged from 39.3% in Hokkaido Prefecture to 63.4% in Tokyo Prefecture. We observed a significant negative correlation between per capita medical expenditures and the proportion of persons receiving specific health examinations (R = 0.553, p < 0.001).<strong> Conclusion: </strong>We found a significant negative correlation between per capita medical expenditures and the proportion of persons receiving health examinations: prefectures with lower expenditures tended to have higher rates of medical examinations. Interventions to increase the proportion of persons receiving specific health examinations by prefecture could reduce per capita medical expenditures and reduce prefectural disparities in expenditures.展开更多
目的比较化疗所致恶心呕吐(chemotherapy-induced nausea and vomiting,CINV)三联(阿瑞匹坦+昂丹司琼+地塞米松)与二联(昂丹司琼+地塞米松)预防方案的非药品次均医疗费用,并分析其影响因素,以期为开展相关药物经济学研究提供数据支撑。...目的比较化疗所致恶心呕吐(chemotherapy-induced nausea and vomiting,CINV)三联(阿瑞匹坦+昂丹司琼+地塞米松)与二联(昂丹司琼+地塞米松)预防方案的非药品次均医疗费用,并分析其影响因素,以期为开展相关药物经济学研究提供数据支撑。方法调取某三级甲等医院电子病历系统中2018年1月1日至2019年9月1日期间患者使用NK-1受体拮抗剂(阿瑞匹坦)和5-羟色胺3受体拮抗剂(昂丹司琼)的连续病例数据,对非药品次均医疗费用进行分层分类描述性分析,并对影响因素进行单因素分析。结果最终纳入404例患者的共计1169住院次的数据。对于非日间化疗病房患者,接受不同致吐性化疗和CINV预防方案的患者非药品次均费用中位数范围为1963.40~2173.05元,日间化疗病房患者为170.96~229.22元。三联与二联预防用药方案的非药品次均医疗费用差异无统计学意义(P>0.05)。单因素分析结果显示,是否属于医保患者是非日间化疗病房患者次均费用的重要影响因素(P<0.05);不同性别、化疗药物致吐性、CINV预防方案类型之间的费用差异均无统计学意义(均P>0.05)。结论化疗所致恶心呕吐三联与二联预防方案的非药品次均医疗费用无差异,是否属于医保患者是非日间化疗病房患者次均费用的重要影响因素。展开更多
文摘Background： Investigate into the medical expenditures of chronic kidney disease （CKD） patients through path analysis method of three consecutive years within a Grade-A tertiary hospital in Beijing to conduct the main influencing factors in diagnosis-related groups （DRGs） grouping of the diagnosis, and reassess the present grouping process to provide information and reference on cost control for hospitals and medical management departments. Methods： Eight hundred and fifty-five inpatient cases whose first diagnosis were defined as CKD in the year 2014-2016 within the hospital were selected as the sample of the study, multiple linear regression and path analysis method were adopted in DRGs grouping process to investigate the main influencing factors of total medical expenditures and DRGs grouping process. Results： The maximum proportion of the medical costs within CKD patients was the costs on treatment, with the highest of 35.3% on the year 2014, the second was the costs on drug, which accounted for 〈30% during consecutive years, and the third was the costs on examination, which accounted for about 20% on average. The main influencing factors of medical expenditures included the type of dialysis, length of hospitalization, the admission of Intensive Care Unit （ICU）, and so on. The coefficients toward the effect for total costs were 0.416, 0.376, and 0.094. respectively. Conclusions： It is suggested that the type of dialysis and the admission of ICU were the major influencing factors of inpatient medical expenditures on CKD patients, and should be taken into consideration into the reassessment of DRGs grouping process to realize the localization and generalization of prospective payment system based on DRGs within the regional area and promote the implementation of medical cost control measures to reduce the economic burdens among patients and the society.
文摘<strong>Background:</strong> Despite having one of the most successful health systems in the world, annual medical expenditures in Japan have been increasing year to year. We sought to clarify regional differences in medical expenditures by analyzing the relationship between the specific health examination coverage and medical care expenditure by prefecture of Japan. <strong>Methods:</strong> We used data from the National Database of Health Insurance Claims and Specific Health Checkups (NDB) Open Data Japan (2015) and Overview of 2015 National Medical Expenses to compare medical care expenditure per capita and proportions of persons receiving specific health examination between Japan nationally and individual prefectures. <strong>Results: </strong>National medical expenditures were 42.3 trillion Japanese yen (JPY) (3851 hundred million dollars), with a national per capita rate of JPY347,219 (USD3156). Per capita medical expenditure rates by prefecture ranged from JPY290,900 (USD2645) in Saitama Prefecture to JPY 444,000 (USD4036) in Kochi Prefecture. The proportion of persons receiving specific health examinations was 49.0% for Japan overall and ranged from 39.3% in Hokkaido Prefecture to 63.4% in Tokyo Prefecture. We observed a significant negative correlation between per capita medical expenditures and the proportion of persons receiving specific health examinations (R = 0.553, p < 0.001).<strong> Conclusion: </strong>We found a significant negative correlation between per capita medical expenditures and the proportion of persons receiving health examinations: prefectures with lower expenditures tended to have higher rates of medical examinations. Interventions to increase the proportion of persons receiving specific health examinations by prefecture could reduce per capita medical expenditures and reduce prefectural disparities in expenditures.
文摘目的比较化疗所致恶心呕吐(chemotherapy-induced nausea and vomiting,CINV)三联(阿瑞匹坦+昂丹司琼+地塞米松)与二联(昂丹司琼+地塞米松)预防方案的非药品次均医疗费用,并分析其影响因素,以期为开展相关药物经济学研究提供数据支撑。方法调取某三级甲等医院电子病历系统中2018年1月1日至2019年9月1日期间患者使用NK-1受体拮抗剂(阿瑞匹坦)和5-羟色胺3受体拮抗剂(昂丹司琼)的连续病例数据,对非药品次均医疗费用进行分层分类描述性分析,并对影响因素进行单因素分析。结果最终纳入404例患者的共计1169住院次的数据。对于非日间化疗病房患者,接受不同致吐性化疗和CINV预防方案的患者非药品次均费用中位数范围为1963.40~2173.05元,日间化疗病房患者为170.96~229.22元。三联与二联预防用药方案的非药品次均医疗费用差异无统计学意义(P>0.05)。单因素分析结果显示,是否属于医保患者是非日间化疗病房患者次均费用的重要影响因素(P<0.05);不同性别、化疗药物致吐性、CINV预防方案类型之间的费用差异均无统计学意义(均P>0.05)。结论化疗所致恶心呕吐三联与二联预防方案的非药品次均医疗费用无差异,是否属于医保患者是非日间化疗病房患者次均费用的重要影响因素。
