辽宁省某市2007—2017年结核病患者住院费用分析
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摘要
目的了解辽宁省某市结核病住院费用情况并探讨其影响因素。方法对辽宁省某市2007年1月—2017年12月出院诊断为结核病住院患者的住院费用进行回顾性分析,共获取有效病例42 356例。结果 2007—2017年间患者人均住院费用呈上涨趋势,由3 674.54元增长到13 722.64元(χ~2=110.00,P=0.00)。药费和检查费占结核病患者的住院费用比例较高,分别为57.90%、23.13%。出院情况、实际住院天数、病人职业、付费方式、医院级别、病人年龄、婚姻状况、病人性别均是结核病患者住院费用的影响因素。结论结核病患者住院费用总体上呈上涨趋势,通过建立结核病规范化临床路径、扩展减免服务项目、提高患者依从性是减轻结核病患者经济负担的关键举措。
Objective To examine hospitalization expenses and its influencing factors in pulmonary tuberculosis patients in a city of Liaoning province. Methods We collected the data on 42 356 pulmonary tuberculosis patients hospitalized from January 2007 through 2017 in a city of Liaoning province and analyzed the data retrospectively. Results The average hospitalization expenses increased from 3 674.54 yuan(RMB) in 2007 to 13 722.64 yuan in 2017 per tuberculosis patient(χ~2 = 110.00, P < 0.01). The proportion of drug fee and examination fee in TB patients were relatively high, accounting for57.90% and 23.13% of the total hospitalization cost. The hospitalization expenses was influenced by the patient's discharge status, hospitalization days, occupation, payment method, age, marital status, gender, and the grade of the hospital being admitted to. Conclusion The hospitalization expenses of tuberculosis patients increased generally during 2007 – 2017 and measures should be taken to reduce financial burden of the patients.
Objective To examine hospitalization expenses and its influencing factors in pulmonary tuberculosis patients in a city of Liaoning province. Methods We collected the data on 42 356 pulmonary tuberculosis patients hospitalized from January 2007 through 2017 in a city of Liaoning province and analyzed the data retrospectively. Results The average hospitalization expenses increased from 3 674.54 yuan(RMB) in 2007 to 13 722.64 yuan in 2017 per tuberculosis patient(χ~2 = 110.00, P < 0.01). The proportion of drug fee and examination fee in TB patients were relatively high, accounting for57.90% and 23.13% of the total hospitalization cost. The hospitalization expenses was influenced by the patient's discharge status, hospitalization days, occupation, payment method, age, marital status, gender, and the grade of the hospital being admitted to. Conclusion The hospitalization expenses of tuberculosis patients increased generally during 2007 – 2017 and measures should be taken to reduce financial burden of the patients.
引文
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[14]Falana A,Akpojiyovwi V,Sey E,et al.Hospital length of stay and cost burden of HIV,tuberculosis,and HIV-tuberculosis coinfection among pregnant women in the United States[J].Am J Infect Control,2017,46(5):564-570.
[15]吴俐健,王笑歌,方继承,等.沈阳和大连市农民工结核病知识知晓率调查[J].中国公共卫生,2017,33(2):284-286.
[16]Menzies NA,Gomez GB,Bozzani F,et al.Cost-effectiveness and resource implications of aggressive action on tuberculosis in China,India,and South Africa:a combined analysis of nine models[J].Lancet Glob Health,2016,4(11):e816-e826.
[17]谷战英,孙强,姚静静.定点医院模式实施前后结核病控制效果分析[J].中国公共卫生,2017,33(01):84-87.
[2]United Nations General Assembly.Transforming our world:the2030 Agenda for Sustainable Development[Z].New York:United Nations General Assembly,2015.
[3]GBD 2015 SDG Collaborators.Measuring the health-related Sustainable Development Goals in 188 countries:a baseline analysis from the Global Burden of Disease Study 2015[J].Lancet,2016,388(10053):1813-1850.
[4]World Health Organization.The end TB strategy[M].Geneva:World Health Organization,2014.
[5]World Health Organization.Global tuberculosis report 2017[R].Geneva:World Health Organization,2017.
[6]Burki TK.The global cost of tuberculosis[J].Lancet Respir Med,2017,6(1):13.
[7]Kundu D,Katre V,Singh K,et al.Innovative social protection mechanism for alleviating catastrophic expenses on multidrugresistant tuberculosispatients in Chhattisgarh,India[J].WHO South East Asia J Public Health,2015,4(1):69-77.
[8]Long Q,Smith H,Zhang TH,et al.Patient medical costs for tuberculosis treatment and impact on adherence in China:a systematic review[J].BMC Public Health,2011,11(4):393-401.
[9]陈民,宋欢,王金龙,等.江苏省三级乙等医院肺结核患者住院费用分析[J].现代预防医学,2017,44(02):275-277+327.
[10]国家卫生与计划生育委员会.2015年我国卫生和计划生育事业发展统计公报[EB/OL].http://www.nhfpc.gov.cn/guihuaxxs/s10748/201607/da7575d64fa04670b5f375c87b6229b0.shtml,[2017-07-20](2016-11-12)
[11]Wolfson LJ,Gibbert J,Wirth D,et al.Cost-effectiveness of incorporating bedaquiline into a treatment regimen for MDR/XDR-TB in Germany[J].European Respiratory Journal,2015,46(6):1826-1829.
[12]Jia XX,Chen JY,Zhang SY,et al.Implementing a"free"tuberculosis(TB)care policy under the integrated model in Jiangsu,China:practices and costs in the real world[J].Infect Dis Poverty,2016,5(1):1.
[13]谢祎,马莲英,马平安,等.肺结核患者住院费用影响因素的通径分析[J].中国慢性病预防与控制,2015,23(7):559-561.
[14]Falana A,Akpojiyovwi V,Sey E,et al.Hospital length of stay and cost burden of HIV,tuberculosis,and HIV-tuberculosis coinfection among pregnant women in the United States[J].Am J Infect Control,2017,46(5):564-570.
[15]吴俐健,王笑歌,方继承,等.沈阳和大连市农民工结核病知识知晓率调查[J].中国公共卫生,2017,33(2):284-286.
[16]Menzies NA,Gomez GB,Bozzani F,et al.Cost-effectiveness and resource implications of aggressive action on tuberculosis in China,India,and South Africa:a combined analysis of nine models[J].Lancet Glob Health,2016,4(11):e816-e826.
[17]谷战英,孙强,姚静静.定点医院模式实施前后结核病控制效果分析[J].中国公共卫生,2017,33(01):84-87.