278例静脉血栓栓塞症医疗保险患者住院费用分析  

Analysis of hospitalization costs for 278 venous thromboeboembolism patients with health insurance in China

作　　者：吴静静[1] 杨莉[1] 

机构地区：[1]北京大学公共卫生学院卫生政策与管理学系,北京100191

出　　处：《北京大学学报（医学版）》2013年第3期437-442,共6页Journal of Peking University:Health Sciences

基　　金：国家自然科学基金(71273016);教育部人文社会科学研究青年基金(10YJC630332)资助~~

摘　　要：目的:对静脉血栓栓塞症(venous thromboembolism,VTE)[包括下肢深静脉血栓形成(deep vein thrombo-sis,DVT)和肺动脉栓塞(pulmonary embolism,PE)]的住院费用及其影响因素进行分析,以便进一步估算其经济负担,为VTE的预防及治疗提供证据。方法:对2009年和2010年基本医疗保险数据库中按照分层随机抽样抽取的278例VTE住院患者的费用进行描述性统计,通过单因素分析和多元线性回归分析其影响因素。结果:数据纳入278例患者,平均年龄为64.4岁,58.3%为男性,61.9%的患者为DVT患者,38.1%为PE患者。平均住院天数为15.8天,DVT患者15.0天,PE患者17.0天。平均住院费用16 487.9元,中位数为9 039.3元,DVT患者平均住院费用17 698.61元,PE患者平均住院费用14 523.4元。多元线性回归显示,住院天数(P<0.001)、地区(P<0.05)、医疗机构级别(P<0.001)、抗凝药物的使用(P<0.001)对VTE患者的住院费用有显著性影响。结论:VTE患者的住院费用相当高,对VTE患者进行规范性预防治疗可能会节省医疗费用。Objective：To determine the hospitalization costs and their predictors for venous thromboembolism （VTE） [ includes deep vein thrombosis （DVT） and pulmonary embolism （PE）] patients with health insurance in China. Methods： In the study, 278 patients with DVT or PE were randomly selected by stratified two-stage sampling from the China Basic Medical Insurance Databases between 2009 and 2010. All the information of the patients＇ demographic characters, length of hospital stay, clinical characters and costs were collected for the analysis. The descriptive statistics, univariate and multivariable analyses were used in the data analysis. Results： All the 278 patients （ mean age, 64.4 years ; 58.3% , male） were evaluated, of whom, 61.9% were with DVT and 38.1% with PE. For all the VTE patients, the mean length-of-hospital stay was 15.8 days （ 15.0 days for DVT patients and 17.0 days for PE patients）. The mean total cost was Chinese Yuan （CNY） 16 487.9 （median： 9 039.1）, CNY 17 698.61 （ median ： 8 643.7） in patients with DVT and CNY 14 523.4 （ median ： 9 879.3 ） in patients with PE. The muhiple linear regressions showed that the factors affecting hospitalization costs were length of hospital stay （ P 〈 0.001 ）, region （ P 〈 0.05 ）, hospital level （ P 〈 0. 001 ）, and type of anticoagu- lants （P 〈 0. 001 ）. Conclusion ： The costs per hospitalization associated with DVT or PE events are substantial, which implies that standard preventions for VTE patients can be cost-saving.

关 键 词：静脉 血栓栓塞 医院费用 

分 类 号：R191[医药卫生—卫生事业管理]