广西壮族自治区和云南省输入性疟疾患者住院费用及其影响因素研究  

Study on the hospitalization cost and its influencing factors of imported malaria patients in Guangxi Zhuang Autonomous Region and Yunnan Province

作　　者：许秋利 林康明[2] 尹授钦 钱门宝 王多全 段磊 陆申宁 李玉星 肖宁 XU Qiu-Li;LIN Kang-Ming;YIN Shou-Qin;QIAN Men-Bao;WANG Duo-Quan;DUAN Lei;LU Shen-Ning;LI Yu-Xing;XIAO Ning(National Institute of Parasitic Diseases,Chinese Center for Disease Control and Prevention(Chinese Center for Tropical Diseases Research),NHC Key Laboratory of Parasite and Vector Biology,WHO Collaborating Centre for Tropical Diseases,National Center for International Research on Tropical Diseases,Shanghai 200025,China;Guangxi Zhuang Autonomous Region Center for Dis-ease Control and Prevention,China;Tengchong Municipal Center for Disease Control and Prevention,Yunnan Province,China;Tengchong Municipal People’s Hospital,Yunnan Province,China)

机构地区：[1]中国疾病预防控制中心寄生虫病预防控制所(国家热带病研究中心)、国家卫生健康委员会寄生虫病原与媒介生物学重点实验室、世界卫生组织热带病合作中心、国家级热带病国际联合研究中心,上海200025 [2]广西壮族自治区疾病预防控制中心 [3]云南省腾冲市疾病预防控制中心 [4]云南省腾冲市人民医院

出　　处：《中国血吸虫病防治杂志》2021年第2期154-161,共8页Chinese Journal of Schistosomiasis Control

基　　金：国家重点研发计划(2016YFC1200502);WHO双年度合作项目(2012/269948-0)。

摘　　要：目的对广西壮族自治区和云南省输入性疟疾病例住院费用及其影响因素进行分析,为评价输入性疟疾导致的经济负担、进而指导疟疾防控并合理配置医疗资源提供参考。方法分别收集2019年1月1日—12月31日在广西壮族自治区上林县人民医院、2015年1月1日—2019年12月31日在云南省腾冲市人民医院就诊的输入性疟疾患者住院费用信息,并从中国寄生虫病防治信息管理系统提取上述病例流行病学个案资料。采用描述性方法对住院费用构成进行分析,应用单因素分析及递归系统模型对患者住院费用的相关影响因素进行分析。结果共纳入输入性疟疾患者206例,其中男性194例(94.17%),女性12例(5.83%);人均住院时长5.00 d;次均中位住院费用2 813.07元,其中化验费占比最高(45.31%,1 274.62元/2 813.07元)。单因素分析显示,医院(z=5.43, P <0.01)、疟疾种类(χ^(2)=34.86, P <0.01)和付费方式(χ^(2)=7.72, P <0.05)是输入性疟疾患者住院费用的影响因素。递归系统模型分析显示,输入性疟疾患者住院费用影响因素按总效应值由大到小排序依次为:住院时长(0.78)、选择医院(0.34)、城乡居民基本医疗保险(0.19)、新型农村合作医疗保险(0.17)、恶性疟(0.15)、性别(0.11)和间日疟(0.09)。结论广西壮族自治区和云南省输入性疟疾患者住院费用受多种因素影响,其中住院时长是最主要的影响因素。通过适当缩短住院治疗时长,可有效控制输入性疟疾患者住院费用。Objective To analyze the hospitalization cost and its influencing factors of imported malaria patients in Guangxi Zhuang Autonomous Region and Yunnan Province,so as to provide insights into the evaluation of the economic burden due to imported malaria,and the guiding of malaria control and the rational allocation of medical resources.Methods The data pertaining to the hospitalization costs of imported malaria patients admitted to Shanglin County People’s Hospital in Guangxi Zhuang Autonomous Region during the period from January 1 through December 31,2019,and Tengchong Municipal People’s Hospital in Yunnan Province from January 1,2015 to December 31,2019,were collected,and the epidemiological data of these imported malaria patients were extracted from the Information Management System for Parasitic Diseases Control and Prevention,China.The composition of the hospitalization expenses was analyzed using a descriptive method.In addition,the factors affecting the hospitalization expenses of imported malaria patients were identified using a univariate analysis and a recursive system model.Results A total of 206 imported malaria patients were included in this study,including 194 men(94.17%) and 12 women(5.83%).The mean length of hospital stay was 5.00 days per patient and the median hospitalization expenses were 2 813.07 Yuan per time,in which the expenses for laboratory examinations were the highest(45.31%,1 274.62/2 813.07).Univariate analysis showed that hospital(z=5.43,P <0.01),type of malaria(χ^(2)=34.86,P <0.01) and type of payment(χ^(2)=7.72,P <0.05) were factors affecting the hospitalization expenses of imported malaria patients.Recursion system modeling revealed that the total effects on hospitalization expenses of imported malaria patients included length of hospital stay(0.78),selection of hospital(0.34),basic medical insurance for urban and rural residents(0.19),new rural cooperative medical care(0.17),Plasmodium falciparum malaria(0.15),gender(0.11) and P.vivax malaria(0.09).Conclusions The hospitali

关 键 词：输入性疟疾 住院费用 影响因素 递归系统模型 广西壮族自治区 云南省 

分 类 号：R531.3[医药卫生—内科学]