医保透析优惠政策对维持性血液透析患者自我感受负担的影响  

Investigation and Analysis of Medical Insurance Dialysis Preferential Policy on Self-perceived Burden of Maintenance Hemodialysis Patients

作　　者：吴秀芳[1] 江红芳[1] 林如[1] 陈均纯 陈华光[1] 唐娟[1] WU Xiufang;JIANG Hongfang;LIN Ru;CHEN Junchun;CHEN Huaguang;TANG Juan(Blood Purification Center,the Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine,Fuzhou Fujian 350003,China)

机构地区：[1]福建中医药大学附属第二人民医院血液净化中心,福建福州350003

出　　处：《中国卫生标准管理》2022年第19期73-78,共6页China Health Standard Management

基　　金：福建中医药大学2021年度校管课题临床专项(XB2021028)。

摘　　要：目的 了解福州市某三甲医院血液净化中心维持性血液透析(maintenance hemodialysis,MHD)患者自我感受负担(selfperceived burden,SPB)状况以及医保透析优惠政策对MHD患者SPB的影响情况。方法 采用自行设计的一般资料问卷和SPB量表对医院2021年1—3月54例患者进行调查,并结合年化门诊费用、个人负担费用进行多元线性回归分析。结果 MHD患者SPB平均得分为(31.46±5.38)分,轻度以上占比90.74%;SPB总分与自理能力呈正相关(P=0.018),与医保类别呈负相关(P=0.099);实行医保透析优惠政策的省医保职工年化个人支付费用低于未实行医保透析优惠政策的市医保职工5 300.39元(P=0.078)、居民15 639.90元(P=0.000)。结论 临床要根据MHD患者SPB影响因素采取相应护理措施;医保透析优惠政策有利于降低MHD患者个人经济负担;建议推广透析优惠政策以降低MHD患者SPB。Objective To investigate the self-perceived burden(SPB of maintenance hemodialysis(MHD) patients in blood purification center of a grade A hospital in Fuzhou and the influence of preferential policies for dialysis of medical insurance on SPB of MHD patients.Methods Fifty-four patients in the hospital from January to March 2021 were investigated by using self-designed general information questionnaire and SPB scale,and combined with the per capita annual outpatient expenses,per capita annual personal expenses to carry out multiple linear regression analysis.Results The average score of SPB in MHD patients was(31.46±5.38),and the proportion of mild or above was 90.74%.SPB score was positively correlated with self-care ability(P =0.018),and negatively correlated with medical insurance category(P =0.099).The annual personal payment of provincial medical insurance employees with preferential medical insurance dialysis policies was 5 300.39 yuan(P =0.078) lower than that of municipal medical insurance employees without preferential medical insurance dialysis policies,and 15 639.90 yuan(P=0.000) for residents.Conclusion Clinical nursing measures should be taken according to the influencing factors of SPB in MHD patients.The preferential policies of medical insurance dialysis is conducive to reduce the personal economic burden of MHD patients.It is suggested to promote preferential dialysis policies to reduce the SPB of MHD patients.

关 键 词：维持性血液透析 自我感受负担 经济负担 基本医疗保险 透析优惠政策 多元线性回归 

分 类 号：R197[医药卫生—卫生事业管理]