辽宁省彰武县新农合心脑血管疾病住院费用支出及影响因素  

Analysis on Cardiovascular and Cerebrovascular Diseases Hospitalization Expenses and Influencing Factors in New Rural Cooperative Medical Care in Zhangwu County of Liaoning Province

作　　者：武惠 周波[1,2] 田沛茹[1,2] 辛芳冉 侯海春 张陆军 时景璞 Wuhui(Department of Clinical Epidemiology and Evidence-Based Medicine,The First Hospital of China Medical University)

机构地区：[1]中国医科大学附属第一医院临床流行病与循证医学教研室,沈阳110001 [2]循证医学教育部网上合作研究中心中国医科大学分中心,沈阳110001 [3]彰武县新型农村合作医疗管理中心,彰武123200 [4]彰武县卫生监督所,彰武123200

出　　处：《医学与社会》2019年第2期47-51,共5页Medicine and Society

摘　　要：目的:了解新农合心脑血管疾病的住院费用及报销现状,为控制医疗费用及制定报销政策提供参考。方法:对辽宁省彰武县2017年1月1日至2017年12月31日住院的参合者中患心脑血管疾病的住院费用进行描述性分析、单因素方差分析及多元逐步回归分析。结果:心脑血管疾病是彰武县参合者的主要慢性疾病,其中冠状动脉疾病所占比例最大。脑出血者人均医疗药费、个人自费及报销费用均高于其他疾病,其自费比例最高,为51.97%;肺源性心脏病的报销补偿比例最高,为69.46%;脑梗的药物花费比例最高,为40.50%;除冠状动脉疾病外其他疾病的人均住院费用在省级医院的花费最高;男性心脑血管疾病的住院费用均高于女性患者;性别、住院天数、医院级别及疾病类型是影响心脑血管疾病住院费用的主要因素(所有P<0.05)。结论:针对不同心脑血管疾病的医疗花费及经济负担,应依据疾病类型及严重程度,选择合理的就诊医院和有效的药物治疗,减少住院时间,以降低参合者心脑血管疾病的住院费用。Objective:To understand the new rural cooperative medical care about the reimbursement and expenses of cardiovascular and cerebrovascular diseases and provide a reference basis for formulating reimbursement policies and controlling medical expenses Methods:The expenses of cardiovascular and cerebrovascular disease inpatients who joined the new rural cooperative medical care from January 1,2017 to December 31,2017 in Zhangwu County,Liaoning Province were analyzed by descriptive analysis,one-way ANOVA and multiple stepwise regression analysis.Results:In new rural cooperative medical care in Zhangwu,circulatory diseases are the major chronic diseases,cardiovascular and cerebrovascular diseases account for the largest proportion.Per capita medical expenses,personal expenses and reimbursement expenses for cerebral hemorrhage are higher than other diseases.Among them,the highest proportion of personal expenses is cerebral hemorrhage for 51.97%,the highest of reimbursement ratio is pulmonary heart disease for 69.46%and the highest proportion of drug costs is cerebral infarction for 40.50%.With the exception of cerebral infarction,the total medical expenses of other diseases are the highest in provincial hospitals.Inpatient medical expenses for male cardiovascular and cerebrovascular diseases are higher than female patients.The main factors affecting the cost of hospitalization for cardiovascular and cerebrovascular diseases were gender,hospitalization days,hospital level and disease type(all P<0.05).Conclusion:The medical costs and economic burden for different cardiovascular and cerebrovascular diseases are different.According to the type and severity of the disease,choosing a reasonable hospital for treatment,choosing an effective drug for treatment,and reducing the length of stay can reduce the cost of inpatient hospital care for cardiovascular and cerebrovascular diseases.

关 键 词：新农合 心脑血管疾病 住院费用 影响因素 

分 类 号：R195.4[医药卫生—卫生统计学]