基于分布拟合法的注射用丹参多酚酸盐治疗冠状动脉粥样硬化性心脏病的住院费用分析
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摘要
目的探讨使用注射用丹参多酚酸盐治疗冠状动脉粥样硬化性心脏病患者的住院费用分布特征,从而为针对性降低医疗费用提供思路,也为进一步的费用研究和药物经济学研究提供依据。方法从河南省安阳市人民医院电子病历数据库中提取使用注射用丹参多酚酸盐治疗的冠状动脉粥样硬化性心脏病患者的费用数据,进行Gamma分布拟合,判断拟合效果,分析费用分布特征。结果患者的总费用和各项二级分类费用均集中分布在费用较低一侧,但有少量病例的费用远高于平均值,分布向右拖尾严重,整体分布为正偏态分布。实际分布和Gamma分布拟合曲线重合度较差,P值均小于0.05。结论接受注射用丹参多酚酸盐治疗的冠状动脉粥样硬化性心脏病患者的住院费用不服从Gamma分布。在接下来的研究中,可以尝试其他分布拟合方法或对样本进行划分,以找到最合适的分布方法,进一步明确冠状动脉粥样硬化性心脏病患者的费用特征。
Objective To explore the hospitalization cost distribution characteristics of coronary heart disease patients using salvianolate injection. Thus we can get ideas for specifically reduce medical costs and get basis for the further cost research and pharmacoeconomics research.Methods We drew the cost data of coronary heart disease patients who received salvianolate injection therapy during their hospitalization from the electronic medical record database of Anyang People's Hospital,a Tertiary Hospital in China. Then we made a gamma distribution fitting,judged the fitting results and analysis the cost distribution characteristics.Results The distribution of total costs and secondary classification's costs were concentrated at the side of the low cost,but costs of a small amount of patients were much higher than average.There was a badly right trailing and it was a positive skewness distribution as a whole.The coincidence degree between actual distribution curve and Gamma distribution fitting curve is poor,P values were less than 0.05.Conclusion The result showed that total medical costs and subcategories costs were skewed positively distribution but they didn't conform to Gamma distribution.For further study,we plan to try other distribution fitting methods or classify the samples,so that we can find the most suitable distribution and make further cognition of the cost characteristics of patients with coronary heart disease.
Objective To explore the hospitalization cost distribution characteristics of coronary heart disease patients using salvianolate injection. Thus we can get ideas for specifically reduce medical costs and get basis for the further cost research and pharmacoeconomics research.Methods We drew the cost data of coronary heart disease patients who received salvianolate injection therapy during their hospitalization from the electronic medical record database of Anyang People's Hospital,a Tertiary Hospital in China. Then we made a gamma distribution fitting,judged the fitting results and analysis the cost distribution characteristics.Results The distribution of total costs and secondary classification's costs were concentrated at the side of the low cost,but costs of a small amount of patients were much higher than average.There was a badly right trailing and it was a positive skewness distribution as a whole.The coincidence degree between actual distribution curve and Gamma distribution fitting curve is poor,P values were less than 0.05.Conclusion The result showed that total medical costs and subcategories costs were skewed positively distribution but they didn't conform to Gamma distribution.For further study,we plan to try other distribution fitting methods or classify the samples,so that we can find the most suitable distribution and make further cognition of the cost characteristics of patients with coronary heart disease.
引文
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[2]陈伟伟,高润霖,刘力生,等.《中国心血管病报告2015》概要[J].中国循环杂志,2016,31(6):521-528.
[3]Yang G,Wang Y,Zeng Y,et al.Rapid health transition in China,1990-2010:findings from the Global Burden of Disease Study 2010[J].Lancet,2013,381(9882):1987-2015.
[4]侯儒寅.冠心病疾病经济负担及影响因素分析[D].哈尔滨:黑龙江中医药大学,2012.
[5]李飞.注射用丹参多酚酸盐联合西药治疗冠心病不稳定性心绞痛临床观察[J].新中医,2016,48(10):16-18.
[6]刘玥,闫盈盈,翟所迪.注射用丹参多酚酸盐治疗心绞痛的系统评价再评价[J].中国临床药理学杂志,2016,32(6):560-562.
[7]赵璇,张晓溪,谢其鑫,等.基于大量数据的北京市冠心病患者费用研究[J]中国卫生经济,2017,36(9):63-68.
[8]江仕清.2013年广西冠心病经济负担及其住院费用影响因素分析[D].南宁:广西医科大学,2017.
[9]伏天伟.医疗费用分布及住院医疗保险费率研究[D].成都:西南财经大学,2016.
[10]蒋炜,夏小亮,吴昱,等.社会健康保险精算中分布拟合模型的应用比较[J].公共卫生与预防医学,2015,26(1):34-38.
[11]Kosaner Kliess M,Kluibenschaedl M,Zoehrer R,et al.Cost-Utility of Partially Implantable Active Middle Ear Implants for Sensorineural Hearing Loss:A Decision Analysis[J].Value Health,2017,20(8):1092-1099.
[12]Corman S,Elbasha EH,Michalopoulos SN,et al.Cost-Utility of Elbasvir/Grazoprevir in Patients with Chronic Hepatitis C Genotype 1Infection[J].Value Health,2017,20(8):1110-1120.