深圳市宝安区肺结核病患者门诊医疗费用及其构成分析  

Outpatient medical expenses and constitutions of tuberculosis patients in Baoan District,Shenzhen City

作　　者：黄建英[1] 钟球 周琳 赵梅桂[3] 陈亮 王云霞[3] 陈维清[1] 

机构地区：[1]中山大学公共卫生学院,广东广州510080 [2]广东省结核病控制中心 [3]深圳市宝安区慢性病防治院

出　　处：《华南预防医学》2014年第2期144-148,共5页South China Journal of Preventive Medicine

基　　金：十二五"艾滋病和病毒性肝炎等重大传染病防治"科技重大专项项目(2012ZX10004903)

摘　　要：目的了解深圳市宝安区肺结核患者确诊后的直接医疗费用及构成,为制定和完善结核病控制策略、优化资源配置提供依据。方法以2008—2012年间在深圳市宝安区慢性病防治院登记管理并完成治疗的初、复治的所有肺结核患者为研究对象,通过结核病管理信息系统、费用信息系统收集肺结核患者的人口学特征、治疗分类、痰检结果、治疗管理方式等基本信息,并对以上信息进行描述性分析,采用多重线性逐步回归分析方法分析影响肺结核患者治疗费用的因素。结果共纳入肺结核患者5 985例,平均年龄为(31.05±10.88)岁,其中男性占63.86%(3 822/5 985),女性36.14%(2 163/5 985);外来流动人口患者占94.72%(5 669/5 985)。调查对象的门诊直接医疗费中位数为2 596.10元,其中人均检查费、辅助药费、其他药费和其他费用的中位数分别为1 512.14、627.50、348.80、43.75元,各项费用总额占总费用的56.81%、24.33%、17.02%、1.84%。本地患者与外地患者、初治与复治患者、初次痰检结果阴性患者与痰检结果阳性患者之间的门诊直接医疗费用的差异均有统计学意义(均P<0.01),以外地患者、复治患者和初次痰检结果阴性患者的治疗费用较高。多重线性逐步回归分析结果显示,外地患者费用高于本地患者(β=0.017,P<0.01),复治患者的费用远远高于初治患者(β=0.093,P<0.01),2月末痰检阳性结果的患者的费用高于阴性者(β=0.048,P<0.01),有空洞的患者的费用高于无空洞者(β=0.043,P<0.01)。结论深圳市宝安区肺结核患者的门诊医疗费用中检查费用所占比例最高,不同类型结核患者的治疗费用存在差异。Objective To investigate direct medical expenses and their constitutions of tuberculo- sis （TB） patients in Baoan District, Shenzhen City, to provide a basis for establishing and perfecting tu- berculosis control strategy and optimizing the allocation of medical resources. Methods All TB patients who were registered and completed the treatment in the Chronic Diseases Prevention and Treatment Hospital of Baoan District from 2008 to 2012 were investigated. The data such as demographic characteristics, thera- py and classification, diagnosis, and therapy management were collected from TB management information system and expense information system. A multiple linear regression model was employed to analyze influ- ential factors of TB treatment expenses. Results A total of 5 985 TB patients aged （31.05± 10. 88 ） years （ mean ± SD） were included in the study. Of them, 63.86% （3 822/5 985） were males, 36. 14% （2 163/5 985） were females, and 94.72% （5 669/5 985） were floating population. The median of out-patient medical expenses was RMB 2 596. 10 Yuan, in which the mean expenses of examination, supportive drugs, other drugs, and other fees were 1 512. 14 （56. 81% ）, 627.50 （24. 33% ）, 348.80 （ 17.02% ）, and 43.75 （ 1.84% ） Yuan, respectively. Nonlocal, retreatment, and smear-negative patients had higher medical expenses than local, initial treatment, and smear-positive patients, respectively （P 〈 0. 01 for all）. Multiple linear regression showed that nonlocal patients had ligher medical expenses than local pa- tients （β = 0. 017, P 〈 0.01 ） , retreatment patients had higher expenses than initial treatment ones （β = 0. 093 ,P 〈0. 01 ）, smear-positive patients at the end of two months had higher expenses than smear-nega- tive ones （β =0. 048 ,P 〈0. 01 ）, and patients with pulmonary cavity had higher expenses than those with- out pulmonary cavity （β = 0. 043, P 〈 0. 01 ）. Conclusion Examination expenses largely accounted for the total outpatient m

关 键 词：肺结核 门诊医疗费用 构成分析 

分 类 号：R521[医药卫生—内科学]