2017—2019年河南省某贫困县县级医疗机构高血压及其合并症、并发症患者住院人次数及住院费用分析  

Number and Costs of Hospitalizations Due to Hypertension and Related Comorbidities and Complications in County-level Healthcare Institutions in a Poverty-stricken County in Henan from 2017 to 2019 LIU Rongmei1,MAO Yanna2,

作　　者：刘荣梅 毛燕娜 刘跟党 赵玉坤 于铭洋 赵秋平[1] LIU Rongmei;MAO Yanna;LIU Gendang;ZHAO Yukun;YU Mingyang;ZHAO Qiuping(Heart Center of Henan Provincial People's Hospital/Fuwai Central China Cardiovascular Hospital/Central China Fuwai Hospital of Zhengzhou University/Henan Key Laboratory for Health Management of Chronic Diseases,Zhengzhou 450003,China;School of Health Management,Southern Medical University,Guangzhou 510515,China;Health and Health Commission of Yiyang County,Luoyang 471699,China)

机构地区：[1]河南省人民医院心脏中心、阜外华中心血管病医院、郑州大学华中阜外医院、河南省慢病健康管理重点实验室,河南省郑州市450003 [2]南方医科大学卫生管理学院,广东省广州市510515 [3]河南省宜阳县卫生健康委员会,河南省洛阳市471699

出　　处：《中国全科医学》2023年第16期2020-2026,2035,共8页Chinese General Practice

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20190807);中国-盖茨基金会农村基本卫生保健项目(OPP1176308);河南省省部共建项目(SB201903022)。

摘　　要：背景2018年,我国≥18岁成人高血压加权患病率为27.5%,农村地区高血压患病率增长速度快于城市,且高血压知晓率、治疗率和控制率较低。高血压是心血管疾病的首要危险因素,同时也是造成人群疾病负担的首要因素。了解农村区域因高血压及其合并症、并发症住院患者的住院费用情况,可为县域制定高血压管理及防控策略提供数据支撑。目的分析县级医疗机构因高血压及其合并症、并发症住院患者的住院费用。方法于2017—2019年在河南省某贫困县人民医院及县中医院,选择病案首页中诊断为高血压患者人群作为研究对象,提取患者相关信息,同时收取市、县医保信息系统中相关的费用信息。结果共获取36565人次住院患者相关信息。总体来看,2017—2019年,县级医疗机构3年累计总住院人次为139169人次,高血压患者累计总住院人次为36565人次(26.27%)。2017—2019年因高血压及其合并症、并发症住院患者年龄、职业类型、婚姻状况、支付方式比较,差异有统计学意义(P<0.05)。不同性别、年龄、职业类型、婚姻状况、入院年份、支付方式的因高血压及其合并症、并发症住院患者病情程度比较,差异有统计学意义(P<0.05)。2017—2019年,因高血压及其并发症、合并症住院患者次均住院费用分别为7364.88、6724.36、7134.09元;因高血压及其并发症、合并症住院患者住院总费用攀升,分别为62653116.87、84394889.48、109633058.60元;因高血压及其合并症、并发症住院患者医保报销在全县医保报销费用中占比分别是24.86%、31.41%、33.25%,呈现逐年上升趋势。不同年份因高血压及其合并症、并发症住院患者次均住院费、治疗费、药品费比较,差异有统计学意义(P<0.05);次均检查费比较,差异无统计学意义(P>0.05)。2017—2019年,不同疾病程度因高血压及其合并症、并发症住院患者次均住院费、治疗费、药Background In 2018,the weighted prevalence rate of hypertension among adults aged≥18 years was 27.5%.Rural areas demonstrated a faster increase in the prevalence rate of hypertension,but lower awareness rate,treatment rate and control rate of hypertension compared with urban areas.Hypertension is the primary risk factor for cardiovascular diseases,and also a major contributor to the disease burden in the population.Understanding the costs of hospitalizations due to hypertension and related comorbidities and complications in rural areas can provide data support for the development of hypertension management and containment strategies in counties.Objective To analyze the costs of hospitalizations due to hypertension and related comorbidities and complications in county-level healthcare institutions.Methods This study selected inpatients with a diagnosis of hypertension via checking the home page of medical records in two county-level hospitals(people's hospital and TCM hospital)of a poverty-stricken county in Henan Province from 2017 to 2019.Patients'clinical information was collected from the medical records,and their healthcare costs were collected from the municipal and county medical insurance information systems.Results A total of 36565 hospitalizations related information was obtained.During the period,these county-level healthcare institutions had 139169 hospitalizations in total,36565 of them(26.27%)were due to hypertension and related comorbidities and complications.Age,occupational type,marital status,and payment method differed significantly across inpatients due to hypertension and related comorbidities and complications(P<0.05).The severity of disease varied significantly among patients hospitalized due to hypertension and related comorbidities and complications by gender,age,occupational type,marital status,year of admission,and payment method(P<0.05).The average cost of hospitalization due to hypertension and related comorbidities and complications was 7364.88 yuan in 2017,6724.36 yuan in 2018,and

关 键 词：高血压 并发症 基层医疗卫生机构 住院 服务费用 医疗 河南 

分 类 号：R544.1[医药卫生—心血管疾病] R197[医药卫生—内科学]