2型糖尿病伴慢性肾脏病患者住院费用及用药分析  

Cost and medications in type 2 diabetes mellitus inpatients with chronic kidney disease

作　　者：梁雪[1] 刘庆婧 陈康[1] 母义明[1] 

机构地区：[1]北京市解放军总医院内分泌科,北京100853 [2]北京北方医药经济健康研究中心

出　　处：《中国慢性病预防与控制》2016年第7期498-501,共4页Chinese Journal of Prevention and Control of Chronic Diseases

摘　　要：目的分析2型糖尿病(T2DM)伴慢性肾脏病(CKD)住院患者的直接医疗费用和治疗模式,为有效控制糖尿病医疗费用提供参考。方法抽取中国医疗保险研究会(CHIRA)数据库中京津两地2010-2012年出院主要诊断为T2DM且无肿瘤或酮症诊断的年龄18岁及以上患者,从中选取810人次T2DM伴有CKD的患者作为研究对象,采用SPSS 20.0及Excel 2013软件对样本人群进行统计分析,研究其住院费用和用药模式。结果研究共纳入T2DM伴CKD患者810人次,占总T2DM患者总人次数的20.1%。患者平均年龄(62.4±11.8)岁,住院天数中位数为15 d,上下四分位数分别为18、11 d。次均住院费用(10 155.68±7 614.79)元,基金支付比例为77.5%。药品费占总费用的47.55%,糖尿病用药费用占总费用的14.06%。次均用药15种化合物。仅使用口服降糖药(OAD)及OAD与胰岛素(INS)联用者分别占13.33%、66.75%。OAD中,阿卡波糖和二甲双胍使用频次最高;伴CKD组与非CKD组相比,OAD单药治疗中二甲双胍频次更高。结论 T2DM伴CKD患者次均住院费用沉重,用药模式复杂,管理充满挑战。应重点关注该类人群的用药合理性。Objective To analyze the direct cost and medication usage pattern in type 2 diabetes mellitus （T2DM） inpatients with chronic kidney disease （CKD）, and to provide the reference for effective medical cost control. Methods The hospitalization records of T2DM inpatients with CKD and without tumors and ketosis in Beijing and Tianjin were from China Health Insurance Research Association （CHIRA） database from 2010 to 2012, 810 T2DM patients with CKD served as the subjects. The data of 810 subjects were analyzed by SPSS 20.0 software and Excel 2013 software to study the medical costs and treatment pattern. Results A total of 810 T2DM inpatients with CKD were included, which were 20.1% of all T2DM inpatients. The mean age was （62.4± 11.8 ） years old. The median and four point spacing of hospital day were 15 days （ 18,1 ldays）. The average cost per admission was 10 155.68±7 614.79 yuan, 77.5% of costs were from foundation. Medication cost was 47.55% of the total cost, medication cost for diabetes was 14.06% of the total cost. Averaged 15 medications per admission were used, 13.33% of the patients used only oral antidiabetic drugs （OAD）, 66.75% of the patients used OAD with insulin （INS）. The used frequencies of acarbose and metformin were the highest in OAD. When the patients with CKD were compared with the patients without CKD, the used freqnency of metformin was the highest in OAD. Conclusion The cost of T2DM patients with CKD per hospitalization is high, the medicine usage pattern is complex. Reasonable utilization of medications for T2DM patients with CKD should be paid attention to.

关 键 词：糖尿病 2型 慢性肾脏病 医疗费用 用药模式 

分 类 号：R587.1[医药卫生—内分泌]