河北省城乡医保居民心血管疾病住院医疗费用构成及影响因素分析  

Hospitalized medical cost constitute of urban and rural insured residents with cardiovascular disease in Hebei province and influencing factors

作　　者：计阿丹[1] 肖倩[1] 马晨东[2] 肖永红[1] 

机构地区：[1]河北联合大学公共卫生学院流行病与卫生统计学科,唐山063000 [2]河北体育学院校医院,石家庄050041

出　　处：《郑州大学学报（医学版）》2014年第2期271-274,共4页Journal of Zhengzhou University(Medical Sciences)

基　　金：河北省社会科学基金项目HB13SH027;2012年河北省社会科学发展研究课题

摘　　要：目的:分析参加城镇居民医疗保险(简称参保)居民和参加新型农村合作医疗(简称参合)居民心血管疾病住院医疗费用构成,探讨其影响因素,为统筹城乡医疗保障制度提供科学依据。方法:选取2011年1月1日至12月31日河北省某县因患心血管疾病住院的参保和参合居民3 947例为研究对象,采用单因素和多重线性回归法分析住院医疗费用的影响因素。结果:参保患者住院医疗费用[(2 959.10±122.67)元]高于参合患者[(2 140.85±53.50)元](t=6.114,P<0.001)。两类患者的住院医疗费用构成中,排名首位的均是药费。参保和参合居民心血管疾病住院医疗费用的共同影响因素有住院时间、入院情况、有无手术和医院级别(标准化的回归系数:参保居民分别为0.204、0.405、0.070和0.163,参合居民分别为0.028、0.082、0.047和0.039)。结论:根据发病程度选择合理的药物治疗,严格掌握手术适应证,减少住院时间,可降低参保和参合居民心血管疾病住院医疗费用。Aim：To analyze the hospitalized medical cost constitute of urban and rural insured residents with cardio -vascular disease , and explore influencing factors , so as to provide scientific basis for urban and rural medical security sys-tem as a whole.Methods：A total of 3 947 hospitalized patients with cardiovascular disease in the medical insurance for urban residents and the new rural cooperative medical care insured residents were selected in a county of Hebei from Janu -ary 1, 2011 to December 31, 2011.Influencing factors of hospitalized medical cost were analyzed with univariate analysis and multivariate regression analysis .Results：The average hospitalized medical cost for the urban residents [（2 959.10 ±122.67） yuan] was significantly higher than that for rural residents [（2 140.85 ±53.50） yuan]（t=6.114,P〈0.001）. In constitute of the hospitalized medical cost , drug cost was ranked first .Hospitalization time , hospitalization status , sur-gery and hospital level were the common influencing factors , which affected the hospitalized medical cost of urban and rural insured residents（standardized βwas 0.204,0.405,0.070 and 0.163 for the urban residents and 0.028,0.082,0.047 and 0.039 for the rural residents）.Conclusion：Drug therapy should be chosen reasonably according to the degree of cardio-vascular disease , and the surgical indications should be commanded strictly to reduce the hospitalization time , so as to re-duce the hospitalized cost .

关 键 词：城镇居民医疗保险 新型农村合作医疗 心血管疾病 住院医疗费用 影响因素 河北省 

分 类 号：R197.1[医药卫生—卫生事业管理]