摘要
目的 了解和分析某社区高血压患者门诊费用情况 ,并对社区心脑血管疾病综合防治模式进行卫生经济学评价。方法 选取实施现场的某社区中 4 6 0名参保高血压患者 ,通过医院的医保结算系统 ,逐次追踪调查了其 2 0 0 2年一年的门诊费用情况 ,并进行统计学分析。结果 高血压患者的年门诊费用情况呈正偏态分布 ,总体上各年龄组的费用水平随着患者年龄的增加而逐渐升高。年门诊费用的中位数为 15 6 7.9元 ,年人均门诊次数 19.5次 ,次均费用 115 .4元。在 4 0～岁和 5 0～岁两年龄组中 ,不同性别间的年门诊费用 (WilcoxonW40～ 49=36 ,P40～ 49=0 .0 37;WilcoxonW50～ 59=374 ,P50～ 59=0 .0 2 3)和年门诊次数比较 (WilcoxonW40～ 49=5 2 .5 ,P40～ 49=0 .0 0 7;WilcoxonW50～ 59=379,P50～ 59=0 .0 2 8)差异有显著性 ,女性明显高于男性。同时考虑到性别和年龄因素时 ,男性各年龄组的年门诊费用(χ2 =2 2 .3,P <0 .0 0 1)和年门诊次数的比较 (χ2 =2 5 .4 ,P <0 .0 0 1)差异也存在显著性。此外 ,在年门诊总费用中 ,药品费用占 83.6 % ;而在药品费用中 ,高血压直接、相关以及无关费用分别占 19.9%、32 .3%和 4 7.8%。结论 为合理测算社区高血压人群干预的成本和效益提供了基本可靠的依据 ;
Objective To study the cost of the hypertensive outpatients. Methods The study randomly selected 460 insured patients with hypertension and investigated their cost on each case in the out-patient department through 2002, based on the electronic system of medical insurance. Results As a whole, the distribution of hypertensive outpatient expenditure takes on the positively skewed, with the median of 1 567.9 Yuan RMB. With the increase of age, the average expenses in each age group increased accordingly. In the study, the average number of outpatient attendances per patient was 19.5 , the average expenses per visit was 115.4 Yuan RMB. In age groups 40-49 and 50-59, expenses of outpatient in male and female groups are obviously different in 2002 (Wilcoxon W 40-49 =36, P 40-49 = 0.037 ;Wilcoxon W 50-59 = 374, P 50-59 = 0.023 ),as well as the number of out- patients (Wilcoxon W 40-49 = 52.5 , P 40-49 = 0.007 ;Wilcoxon W 50-59 =379, P 50-59 = 0.028 ). When considering the factors of gender and age at one time, the outpatient expenditures in the male group were significantly different between the different age groups ( χ 2= 22.3 , P < 0.001 ),as well as the number of outpatients ( χ 2= 25.4 , P < 0.001 ). In addition, the expenditure of drugs, which took a large proportion of the total expenditure of hypertensive outpatients (about 83.6 percent), was divided into three parts according to the degree of correlation with hypertension: direct expenses related to the with disease, the indirect expenses and the irrespective. The proportions of each part were 19.9 percent, 32.3 percent and 47.8 percent respectively. Conclusion When economic evaluation of community prevention is carried out, the cost and cost-benefit analysis based on the analysis of outpatient expenditure and the proportion of expenses on hypertension should be taken into account. Additionally, to provide appropriate mode of medicare, to impact the behaviors and expenditure of patients, and to provide low-cost but good effective drug are also essential and important factors.
出处
《中华流行病学杂志》
CAS
CSCD
北大核心
2003年第12期1074-1077,共4页
Chinese Journal of Epidemiology
基金
国家"十五"科技攻关课题资助项目 (2 0 0 1BA70 3B0 2 )
