重庆市血液透析患者门诊医疗费用分析  

Analysis of outpatient medical expenses of hemodialysis patients in Chongqing City

作　　者：廖元江[1] 石艳[1] 高小玲[1] LIAO Yuanjiang;SHI Yan;GAO Xiaoling(Chongqing Municipal Ninth People′s Hospital,Chongqing 400700,China)

机构地区：[1]重庆市第九人民医院,400700

出　　处：《重庆医学》2021年第21期3760-3764,共5页Chongqing medicine

基　　金：重庆市卫生经济委员会科研项目(YWJK2017-7)。

摘　　要：目的分析重庆市样本医院血液透析(血透)患者门诊医疗费用的分布和影响因素,以促进对该市血透患者医疗费用管控的思考。方法收集重庆市两家三甲医院2018年共364例血透患者门诊医疗费用情况,对患者基本信息和门诊费用进行描述性统计分析。使用t检验、单因素方差分析比较不同人口学变量患者门诊费用的差异,使用logistic回归模型分析探索患者门诊医疗费用的影响因素。结果90.74%血透患者的费用由国家医疗保险报销,药品费用占门诊医疗费用38.06%,治疗费和材料费分别占37.05%、22.69%。患者年龄是否大于55岁、透析龄是否大于60个月、是否合并高血压、Charlson指数水平高低是血透患者门诊总费用的影响因素。年龄是否大于55岁、是否并发心血管疾病是血透患者门诊药品费用的影响因素。合并症Charlson指数高低是血透患者门诊治疗费用的影响因素。结论该市血透患者门诊医疗费用报销比例较高,但费用结构不合理。血透患者年龄、透析龄、是否并发高血压、是否并发心血管疾病,以及Charlson指数得分是影响患者门诊费用、药品费用和治疗费用的主要因素。Objective To analyze the distribution and influence factors of outpatient medical expenses of hemodialysis patients in the sample hospitals of Chongqing City in order to promote the thinking of the medical expenses management and control of hemodialysis patients in this city.Methods The informations of outpatient medical expenses in 364 hemodialysis patients were collected from 2 class 3A hospitals of Chongqing City during 2018,and the basic information and outpatient expenses conducted the descriptive statistical analysis.Then the t-test and one-way ANOVA were used to compare the differences of the outpatient expenses among the patients with different demographic variables,and the logistic regression analysis was used to explore the influence factors of the outpatient medical expenses.Results 90.74%of the expenses in hemodialysis patients was reimbursed by the National Medical Insurance.The drug expenses accounted for 38.06%of the outpatient medical expenses,and the expenses of therapy and materials accounted for 37.05%and 22.69%respectively.Whether the patient′s age being over 55 years old,dialysis age over 60 months,whether complicating hypertension and the Charlson index level were the influence factors of the total outpatient medical expenses of the hemodialysis patients.Whether the patient being over 55 years old and complicating cardiovascular disease were the influence factors of the outpatient drug expenses of hemodialysis patients.The level of Charlson index in complications was the influence factor of the outpatient therapy expenses.Conclusion The reimbursement proportion of the outpatient medical expenses of hemodialysis patients in this city is high,but the expense structure is unreasonable.The age,dialysis age,whether complicating hypertensin and cardiovascular disease,and the Charlson index score are the main factors affecting the outpatient expenses,drug expenses and therapy expenses of hemosialysis patients.

关 键 词：血液透析 门诊医疗费用 影响因素 

分 类 号：R19[医药卫生—卫生事业管理]