四家不同类别医疗机构尘肺病人住院费用特征及其影响因素  

Inpatient expenses of pneumoconiosis patients in four types of medical institutions and its influencing factors

作　　者：余悦 赵凤玲 潘宏伟 姚开娟 YU Yue;ZHAO Fengling;PAN Hongwei;YAO Kaijuan(National Institute of Occupational Health and Poison Control,Chinese Center for Disease Control and Prevention,Beijing 100050,China;Henan Provincial Institute for Occupational Health,Zhengzhou,Henan 450052,China;Institute of Occupational Disease Prevention and Control of China Pingmei Shenma Group,Pingdingshan,Henan 467001,China;Xinxiang Institute of Occupational Disease Prevention and Control,Xinxiang,Henan 453000,China)

机构地区：[1]中国疾病预防控制中心职业卫生与中毒控制所,北京100050 [2]河南省职业病防治研究院,河南郑州450052 [3]中国平煤神马集团职业病防治院,河南平顶山467001 [4]新乡市职业病防治研究所,河南新乡453000

出　　处：《环境与职业医学》2021年第5期505-510,共6页Journal of Environmental and Occupational Medicine

摘　　要：[背景]国内有研究者对尘肺病的经济负担进行了一些调查研究,但多数调查是基于某一个企业或医疗机构开展的,全国性的和地区性的调查研究数据尚少。[目的]分析某省不同类别医疗机构尘肺病人的住院医疗费用,为政府有关部门制定尘肺病治疗救助费用管理措施,减轻尘肺病经济负担提供参考依据。[方法]选取2019年某省四家不同类别医疗机构,利用出院病历档案资料对446例男性尘肺病人各种住院医疗费用进行调查。采用Kruskal-Wallis H检验方法对不同类型医疗机构、年龄、文化程度、用工方式、病种、有无合并症、费用支付方式组间总费用、日均费用、治疗护理费、检查化验费、药费和其他费用的差异进行比较分析。采用多元逐步回归分析用工方式、年龄、合并症、病种、文化程度、费用支付方式对总费用和日均费用的影响。[结果]企业三甲医院、企业职防院、省级职防院、市级职防院等四家医疗机构之间住院总费用(15183.94、8367.65、15325.82、8137.48元)、日均费用(377.28、283.89、541.85、168.47元)、治疗护理费(5668.50、6040.10、2994.00、1517.00元)、检查化验费(1953.00、845.55、1542.90、617.00元)和药费(6780.59、1431.52、10798.50、3209.80元)差异具有统计学意义(P<0.01)。单因素分析结果显示不同年龄、文化程度、用工方式、病种、有无合并症和支付方式组间住院费用、日均费用、治疗护理费、检查化验费、药费和其他费用等差异均具有统计学意义(P<0.05)。多元逐步回归分析结果显示合并症、用工方式、病种、年龄和支付方式是总费用的影响因素(P<0.05),其中合并症的影响最大(R^(2)=0.065,b=-0.262)。用工方式、年龄、合并症、文化程度、支付方式和病种是日均费用的影响因素(P<0.05),其中用工方式的影响最大(R^(2)=0.226,b=0.614)。[结论]不同类别医疗机构治疗尘肺病的费用不�[Background]Domestic research on the economic burden of pneumoconiosis has been reported,but most of them are based on one enterprise or medical institution,and national and regional survey data are scarce.[Objective]This study analyzes the inpatient medical expenses of pneumoconiosis patients in different types of medical institutions in a province of China,aiming to provide insights for relevant government departments to formulate management measures of pneumoconiosis treatment and relief expenses and to reduce the economic burden of pneumoconiosis.[Methods]Four medical institutions of different types in a province in 2019 were selected to investigate inpatient medical expenses of 446 male pneumoconiosis patients using the data from medical records.Kruskal-Wallis H test was used to analyze the differences of total expenses,average daily expenses,treatment and nursing care expenses,examination and laboratory fees,drug cost,and other cost among the patients in different categories of medical institution,age,education level,employment type,disease,comorbidity,and payment method.Multiple stepwise regression models were used to analyze the influences of employment type,age,educational level,comorbidity,disease,and payment method on total expenses and average daily expenses.[Results]There were significant differences in the total expenses(15183.94,8367.65,15325.82,and 8137.48 yuan),average daily expenses(377.28,283.89,541.85,and 168.47 yuan),treatment and nursing care expenses(5668.50,6040.10,2994.00,and 1517.00 yuan),examination and laboratory fees(1953.00,845.55,1542.90,and 617.00 yuan),and drug cost(6780.59,1431.52,10798.50,and 3209.80 yuan)among the four medical institutions,namely,corporate class A hospital,corporate occupational disease hospital,provincial occupational disease hospital,and municipal occupational disease hospital(P<0.01).The results of Kruskal-Wallis H test showed that there were significant differences in total expenses,average daily expenses,treatment and nursing care expenses,examination and

关 键 词：尘肺病 住院医疗费用 职业病 

分 类 号：R135[医药卫生—劳动卫生]