摘要
目的对基层医疗机构慢性病患者住院费用进行分析,了解住院费用的影响因素,为慢性病住院费用控制提供依据。方法采用调查表收集2008年湖南省12所基层医疗机构6种慢性病住院病人的住院费用资料,应用SPSS16.0软件包描述患者的住院费用并分析影响因素。结果慢性病的次均住院天数、住院费用、药品费、检查费和化验费为10.6天、2626.4元、1279.8元、190.5元和335.5元,药品费、检查费和化验费合计占住院费近70.0%;脑梗塞、冠心病、慢性阻塞性肺病(COPD)、糖尿病、高血压和慢性支气管炎的次均住院费用为3385.8元、2692.4元、2882.5元、2970.2元、2244.6元和2064.6元;城市二级医院、农村县医院和乡镇卫生院的次均住院费用为3402.2元、3046.0元和1167.9元;药品费在城市二级医院、农村县医院和乡镇卫生院中占50.5%、45.4%和56.1%;多因素分析提示年龄、住院天数、医疗制度、职业、慢性病种类及基层医院类型是慢性病患者住院费用的影响因素。结论基层医疗机构6种慢性病次均住院费用为2626.4元,明显低于大型综合性医院住院费用平均水平,住院费用几乎一半来自药品费用,脑梗塞的住院费用最高,年龄越大、住院天数越多、有医疗保障制度、非农村劳动者、丧偶和城区医院的住院患者其慢性病住院费用相对较高。
OBJECTIVE On the basis of hospital expense analysis of chronic diseases, to study their determinants and provide some suggestions in chronic disease management. METHODS Questionnaire was used to collect information of hospitalization expenditure among patients with six chronic dieases of 12 primary hospitals in Hu＇nan Province in 2008. SPSS 16.0 for Windows was used to analyze and explore the determinants. RESULTS In the current study, we found that among the primary hospitals the average of the total hospitalization expenditure per time for chronic dieases was 2 626.4 yuan, the average length of staying in hospital was 10.6 days.the cost for drug, inspection and laboratory test per time were 1 279.8 yuan, 190.5 yuan and 335.5 yuan, respectively, the total of which was around 70%. The average expenditure for cerebral infarction, coronary disease, COPD, diabetes mellitas, hypertension and chronic bronchitis was 3 385.8 yuan, 2 692.4 yuan, 2 882.5 yuan, 2 970.2 yuan, 2 244.6 yuan and 2 064.6 yuan. The average of the total hospitalization expenditure per time in second-class hospital of city areas, county hospital in rural areas and public health center in towns was 3 402.2 yuan, 3 046 yuan and 1 167.9 yuan. The proportion of drug cost insecond-class hospital of city areas, county hospital of rural areas and public health center in towns was 50.5%, 45.4% and 56.1%. Multifactorial analysis showed that patients＂ age and occupation, length of hospital day, medical system, kind of chronic disease and type of primary hospital , were associated with hospitalization expenditure for chronic diseases. CONCLUSION Among the primary hospitals the average of the total hospitalization expenditure per time for chronic dieases was2 626.4 yuan, which is obviously lower than large comprehensive hospital expenses. Almost half of total hospital expenses is from drug expenses. Cerebral infarction hospitalization expense is highest, the older they get, the more days in hospital, having medical institution, the rural laborer, widowed, and downtown hospital inpatients in its chronic disease hospital expenses was relative taller.
出处
《中国初级卫生保健》
2012年第2期6-10,共5页
Chinese Primary Health Care
基金
美国中华医学基金会资助(08-926)
关键词
慢性病
住院费用
基层医疗机构
影响因素
卫生服务
卫生经济
chronic dieases
hospitalization expenditure
primary hospital establishment
influencing fator
health services
health economic
