农村精神障碍患者住院费用调查及管控对策研究——基于对甘肃省“4个区域”“6个中心”的实证分析
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摘要
目的:调查农村精神障碍患者住院费用及影响因素,探索其管控对策。方法:采用整群抽样、回顾性研究及对照分析等方法,将定性研究与定量研究相结合,对甘肃省"4个区域""6个中心"19 162例农村精神障碍患者住院费用及影响因素进行对照分析。结果:甘肃省农村精神障碍患者住院费用呈逐年上涨趋势,专科医院住院天数、次均费用和实际报销比例高于综合性医院,综合性医院日均费用高于专科医院。结论:甘肃农村精神障碍患者疾病负担沉重,因病致贫、因病返贫、肇事肇祸等问题应引起全社会共同关注,建议三方协同合理控费、多部门协作一站式救助,切实减轻疾病负担,有效发挥管控合力,以帮助患者早日回归社会,助力健康中国。
Objective:To investigate hospitalization expense of rural patients with psychogenia and the influencing factors, and explore the control countermeasures. Methods: Using cluster sampling, retrospective study,control analysis, and other method, combining qualitative investigation with quantitative study, hospitalization expense of 19 162 rural patients suffering psychogenia from "six centers" and four regions of Gansu province were analyzed. Results: Hospitalization expense of rural patients suffering psychogenia increased year by year, special hospital was higher than general hospital in hospitalization days, average cost and actual reimbursement ratio,general hospital was higher than special hospital in daily average cost. Conclusion: Rural patients with psychogenia from Gansu province are bearing the heavy burden, the issues containing illness-caused poverty, accidents and disasters come to public attention, therefore to raise the measures including reasonable controlling expense by tripartite cooperation, one-stop rescue through many departments coordination, which could reduce the disease burden conscientiously, effectively develop the control force, in order to help the patients return to the society and boost "healthy Chinese".
Objective:To investigate hospitalization expense of rural patients with psychogenia and the influencing factors, and explore the control countermeasures. Methods: Using cluster sampling, retrospective study,control analysis, and other method, combining qualitative investigation with quantitative study, hospitalization expense of 19 162 rural patients suffering psychogenia from "six centers" and four regions of Gansu province were analyzed. Results: Hospitalization expense of rural patients suffering psychogenia increased year by year, special hospital was higher than general hospital in hospitalization days, average cost and actual reimbursement ratio,general hospital was higher than special hospital in daily average cost. Conclusion: Rural patients with psychogenia from Gansu province are bearing the heavy burden, the issues containing illness-caused poverty, accidents and disasters come to public attention, therefore to raise the measures including reasonable controlling expense by tripartite cooperation, one-stop rescue through many departments coordination, which could reduce the disease burden conscientiously, effectively develop the control force, in order to help the patients return to the society and boost "healthy Chinese".
引文
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[15]梁仕兰.58例住院精神病患者发生危险行为相关因素及护理对策[J].西部中医药,2014,27(6):150-151.
[16]马晓明.中西药联用治疗颅脑损伤致精神障碍39例[J].西部中医药,2016,29(8):121-122.
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[19]邝宇香.慢性胃炎患者情志致病的SCL-90量表调查研究[J].河北中医,2008,30(8):816-817.
[2]李向青,卢颖,任利华,等.中国精神疾病流行病学调查能研究[J].现代预防医学,2014,41(19):3489-3490.
[3]赵文莉,格鹏飞,蒋霞,等.甘肃省重性精神疾病现况调查[J].中国公共卫生,2016,32(6):765-769.
[4]孙梅,李程跃,吕军,等.界定与测量农村居民因病致贫:新型农村合作医疗保险方案研制思路之四[J],中国卫生资源,2013,16(3):160-162.
[5]王冰洁,李喜平.5439例精神疾病患者住院费用影响因素分析[J].中国医院统计,2013,20(1):30-36.
[6]鲁迎春,何静.慢性精神分裂症患者家属疾病负担状况及其影响因素[J].中国公共卫生管理,2015,31(1):94-96.
[7]李杨.甘肃省现有30多万名精神障碍患者[N].西部商报,2016-07-26.
[8]赵东荣,郭建康,吕凤燕,等.甘肃省精神疾病患者社会支持系统的现况调查[J].兰州大学学报:医学版,2013,39(2):65-68.
[9]王东进.理性推进三医联动合力建设健康中国[J].中国医疗保险,2017,18(1):1-4.
[10]张国林,梁成智,李芳.定西市2010—2012年重性精神疾病流行特征分析[J].西部中医药,2016,29(1):88-90.
[11]高君侠.常州市遥观镇2013年重性精神疾病流行病学分析[J].中国医药科学,2015,5(5):196-198.
[12]甘培艳,杨晋梅,何武伟,等.农村精神障碍患者门诊疾病负担调查及救助机制探讨[J].西部中医药,2017,30(12):41-44.
[13]姚丰菊,王长虹,秦志华,等.农村重性精神疾病患者应急处置机制探讨[J].中国医药科学,2014,4(1):173-174.
[14]曹菊玲.精神科开放病房患者意外事件发生因素研究[J].西部中医药,2016,29(9):74-76.
[15]梁仕兰.58例住院精神病患者发生危险行为相关因素及护理对策[J].西部中医药,2014,27(6):150-151.
[16]马晓明.中西药联用治疗颅脑损伤致精神障碍39例[J].西部中医药,2016,29(8):121-122.
[17]张淑萍,阮学平,段红梅,等.中医药治疗精神分裂症的文献引文分析[J].西部中医药,2015,28(5):69-72.
[18]于洋,田铁石,周琳.精神疾病临床用药分析[J].中国医药科学,2015,5(15):48-50.
[19]邝宇香.慢性胃炎患者情志致病的SCL-90量表调查研究[J].河北中医,2008,30(8):816-817.