肾性高血压住院患者用药特点及经济负担研究  

Medication characteristics and economic burden of inpatients with renal hypertension

作　　者：刘俏[1,2] 许清青 郑绘[4] 易利丹[1,2] 罗霞[1,2] LIU Qiao;XU Qing-qing;ZHENG Hui;YI Li-dan;LUO Xia(Department of Pharmacy,the Second Xiangya Hospital of Central South University,Changsha 410011;Institute of Clinical Pharmacy,Central South University,Changsha 410011;School of Public Administration,Central South University,Changsha 410002;Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610075)

机构地区：[1]中南大学湘雅二医院药学部,长沙410011 [2]中南大学临床药学研究所,长沙410011 [3]中南大学公共管理学院,长沙410002 [4]成都中医药大学附属医院,成都610075

出　　处：《中南药学》2023年第11期3045-3050,共6页Central South Pharmacy

基　　金：湖南省自然科学基金(No.2021JJ40817,No.2022JJ80040);湖南省卫健委科研项目(No.202113050611,No.202113050283,No.202213053462)。

摘　　要：目的分析肾性高血压住院患者的用药特点与经济负担,为减轻患者经济负担及优化卫生资源的合理配置提供依据。方法回顾性收集整理某大型综合医院2019年1月1日至2022年9月30日的肾性高血压住院患者信息,分析用药特点、逐年住院费用变化、各项住院费用变化、各临床特征与住院费用的相关关系,多元逐步回归分析住院费用影响因素。结果共纳入3286例患者,以男性、30~60岁、湖南患者居多。用药种类数为(2.69±1.51)种,使用两类药物进行治疗的患者最多。以DDDs总值为指标排序,使用最多的是钙离子通道阻滞剂、α受体阻滞和血管紧张素Ⅱ受体拮抗剂类。住院总费用均值为(39690.53±85305.44)元,中位数为10797.83元,P25~P75为7130.48~20677.13元;西药费均值为(10206.41±24170.42)元,中位数为1961.61元,P25~P75为857.25~5012.93元。单因素回归分析结果提示患者性别、年龄、住院天数、是否进行肾移植以及当前肾脏病所处分期对住院总费用的影响差异均有统计学意义(P<0.05)。多元逐步回归分析结果提示对人均住院总费用的影响程度从大到小依次为住院天数、是否进行肾移植、当前肾脏病所处分期、性别和年龄。结论肾性高血压患者由于需要多种药物联合治疗,住院天数以及是否进行肾移植是肾性高血压患者住院总费用影响程度最大的因素,通过早筛查早诊断早治疗、制订合理的和个性化的药物治疗方案、进行药物经济学研究等措施可以在一定程度上降低肾性高血压患者的经济负担。Objective To analyze the medication characteristics and economic burden of inpatients with renal hypertension to reduce the economic burden of patients and better allocate health resources.Methods The information of inpatients with renal hypertension from January 1st,2019 to September 30th,2022 in a major hospital was retrospectively collected.The medication characteristics,year-byyear changes in hospitalization costs,changes of items costs in various inpatients,the relationship between various clinical features and inpatient costs were determined,and the influencing factors of inpatient costs were analyzed by multiple stepwise regression.Results Totally 3286 patients were included,mostly males,aged 30~60 and from Hunan.The number of drug types was(2.69±1.51),the two-drug combination regimen was most common in the medication regimen.With the ranking of total value of DDDs as an indicator,the drugs used most frequently included calcium channel blocker(CCB),alpha-blockers and angiotensin receptor blocker(ARB).The mean total cost of hospitalization was(39690.53±85305.44)yuan(median:10797.83 yuan;P25~P75:7130.48~20677.13)yuan.The mean cost of western drug was(10206.41±24170.42)yuan,(median:1961.61 yuan,P25~P75:857.25~5012.93 yuan).Univariate regression showed that the effects of gender,age,the number of hospitalization days,whether undergoing kidney transplantation,and current stage of renal disease on the total cost of hospitalization were statistically significant(P<0.05).The multiple stepwise regression showed that the impact on the total cost of hospitalization per capita was the number of hospitalization days,whether undergoing kidney transplantation,stage of current kidney disease,gender and age in order of strong to weak.Conclusion Due to the need for a combination of drugs,the number of hospitalization days and whether or not to undergo kidney transplantation are the most important factors for the total cost of hospitalization of patients with renal hypertension.The economic burden of patients with renal h

关 键 词：肾性高血压 经济负担 住院费用 药物治疗 

分 类 号：R284.1[医药卫生—中药学] R917.101[医药卫生—中医学]