| 引用本文: |
奉祁薇,闫春晓.湖南省慢阻肺患者住院费用影响因素分析[J].湖南中医药大学学报,2023,43(4):740-746[点击复制] |
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| 湖南省慢阻肺患者住院费用影响因素分析 |
| 奉祁薇,闫春晓 |
| (湖南中医药大学, 湖南 长沙 410208) |
| 摘要: |
| 目的 分析慢阻肺患者住院费用影响因素，为规范慢阻肺防治、完善医保政策、降低患者疾病经济负担提供参考。方法 通过多阶段分层抽样收集湖南省慢阻肺住院病例24 795例。运用描述性分析、非参数秩和检验、Spearman秩相关分析及多重线性回归分析，分析慢阻肺患者住院费用水平及其影响因素。结果 年龄、性别、住院天数、付费方式、合并症情况、手术情况、机构等级等7个变量的住院费用存在显著组间差异（P<0.001）。性别、年龄、住院天数、机构等级等14个变量均与住院费用显著相关（P<0.001），其中药品费与住院费用相关系数高达0.838。年龄、住院天数、药占比、机构等级、合并症情况及手术情况均对住院费用影响显著（P<0.001），性别对住院费用存在一定影响（P=0.002），医保补偿比对住院费用无显著影响（P=0.362）。男性慢阻肺住院患者较多且费用较高。年龄越大或机构等级越高，住院费用越高。有合并症或手术的患者住院费用更高，但医保补偿比更低。结论 应重视生活习惯对慢阻肺患者的影响，加强慢阻肺的早期筛查、干预、用药规范与指导，充分发挥中药低价优势，合理缩短平均住院日，进一步落实分级诊疗制度，加大对有合并症或手术患者的医保补偿力度。 |
| 关键词: 慢阻肺 住院费用 多重线性回归分析 影响因素 住院天数 机构等级 药占比 医保补偿比 |
| DOI：10.3969/j.issn.1674-070X.2023.04.027 |
| 投稿时间：2022-11-17 |
| 基金项目:湖南省卫生健康委员会项目（2021A01，2021Y04）。 |
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| Influencing factors of hospitalization expenses of patients with chronic obstructive pulmonary disease in Hunan Province |
| FENG Qiwei,YAN Chunxiao |
| (Hunan University of Chinese Medicine, Changsha, Hunan 410208, China) |
| Abstract: |
| Objective To analyze the influencing factors of hospitalization expenses of patients with chronic obstructive pulmonary disease (COPD), so as to normalize the prevention and treatment of COPD, to develop medical insurance policies and to alleviate the economic burden of patients.Methods A total of 24 795 COPD cases in Hunan Province were collected by multi-stage stratified sampling. Descriptive analysis, non-parametric rank sum test, Spearman rank correlation analysis and multiple linear regression analysis were used to identify the hospitalization expense levels of COPD patients and the influencing factors.Results We found obvious group difference in 7 variables: age, gender, hospital stay, payment way, complication status, operation, hospital grade. In addition, we found significant group differences (P<0.001) in hospitalization expenses for 14 variables, including age, gender, hospital stay, and hospital level. The coefficient of correlation between pharmaceutical costs and hospitalization expenses achieved 0.838. Age, hospital stay, medicine proportion, hospital level, complication status, and surgery all had significant effects on hospitalization expenses (P<0.001); gender also affected hospitalization expenses (P=0.002); health insurance reimbursement ratio had no significant effect on hospitalization expenses (P=0.362). More men than women were hospitalized for COPD and men's expenses were higher. With the older age or the higher hospital level, the expenses of hospitalization increased. Patients with complications or surgery had higher hospitalization expenses, but lower health insurance reimbursement ratio.Conclusion Attention should be paid to the living habits of COPD patients. Also, we need to strengthen the early screening and intervention, as well as the standardization and guidance of medication administration. In addition, we can fully take the cost advantages of Chinese medicine, reasonably shorten the average hospital stay, further implement the hierarchical medical system, and increase health insurance reimbursement for COPD patients with complications or surgery. |
| Key words: chronic obstructive pulmonary disease hospitalization expense multiple linear regression analysis influencing factors hospital stay hospital level medicine proportion health insurance reimbursement ratio |
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