糖尿病门诊治疗费用变化趋势及影响因素分析  

An analysis of trends in and influencing factors of outpatient treatment costs for diabetes

作　　者：刘杰 黎卫平[3] 何静 吴君桐 陈永聪[1] 马永恒 魏玉辉[5] 赵德芳 Liu Jie;Li Weiping;He Jing;Wu Juntong;Chen Yongcong;Ma Yongheng;Wei Yuhui;Zhao Defang(School of Public Health,Lanzhou University,Lanzhou 730000,China;Lanzhou University Hospital,Lanzhou 730030,China;School of Basic Medical Sciences,Lanzhou University,Lanzhou 730000,China;Gansu Provincial Public Resource Trading Center,Lanzhou 730000,China;Department of Pharmacy,The First Hospital of Lanzhou University,Lanzhou 730030,China)

机构地区：[1]兰州大学公共卫生学院,兰州730000 [2]兰州大学校医院,兰州730030 [3]兰州大学基础医学院,兰州730000 [4]甘肃省公共资源交易中心,兰州730000 [5]兰州大学第一医院药剂科,兰州730030

出　　处：《保健医学研究与实践》2023年第12期112-118,共7页Health Medicine Research and Practice

基　　金：国家第六批药物集中带量采购政策控费效果研究(横20220401)。

摘　　要：目的分析国家第六批药品集中带量采购(胰岛素专项)政策在甘肃省某三甲医院实施后对糖尿病门诊治疗费用的影响。方法收集2019年1月1日—2023年5月14日于甘肃省某三甲医院门(急)诊就医的全部第一诊断为糖尿病的患者的处方信息,将2019年1月1日—2022年5月14日划分为“国家第六批药品集中带量采购政策实施前”(简称“政策前”),将2022年5月15—2023年5月14日划分为“国家第六批药品集中带量采购政策实施后”(简称“政策后”),采用描述性分析、单因素方差分析、多元线性回归分析等方法分析门诊处方情况、费用影响因素及变化趋势。结果共收集380798张糖尿病患者门诊处方,其中政策前273989张,政策后106809张;患者平均年龄为(64.08±13.33)岁,60~79岁患者占53.45%;诊断糖尿病伴有并发症处方占87.30%,年均增长率为6.57%;全部处方中含有胰岛素的处方66867张(17.56%)。单因素分析显示,不同时间、性别、年龄、糖尿病类型及处方是否含胰岛素、国家第六批药品集中带量采购政策实施前后情况不同的处方金额对数的差异均具有统计学意义(P<0.05);多元线性回归分析显示,时间、性别、年龄、药物种类数、胰岛素种类数、国家第六批药品集中带量采购政策实施情况均为药物处方金额的影响因素(P<0.05):各年度的处方金额均低于2019年;女性患者的处方金额低于男性;相对于<20岁年龄组,其余各年龄组患者处方金额均较高;药物种类数、胰岛素种类数均与处方金额呈正相关;国家第六批药品集中带量采购政策实施后处方金额更低。结论影响糖尿病治疗费用的主要因素包括时间、性别、年龄、糖尿病类型、胰岛素治疗、国家第六批药品集中带量采购政策实施情况等。国家第六批药品集中带量采购政策的实施切实降低了糖尿病患者治疗的经济负担,应扩大药品集中带量采购范围,进�Objective To analyze the impact of the implementation of the National Centralized Drug Procurement Policy for Insulin on outpatient treatment costs for diabetes in a grade A tertiary hospital in Gansu Province.Methods Prescription information of all patients with a first diagnosis of diabetes who visited the outpatient department of a grade A tertiary hospital in Gansu Province from January 1,2019 to May 14,2023 was collected for this study.The period from January 1,2019 to May 14,2022 was divided into“pre-implementation of the National Centralized Drug Procurement Policy”(referred to as“pre-policy”),and the period from May 15,2022 to May 14,2023 into“post-implementation of the National Centralized Drug Procurement Policy”(referred to as“post-policy”).Descriptive analysis,one-way analysis of variance,and multiple linear regression analysis were used to analyze outpatient prescription patterns,influencing factors of costs,and trends.Results A total of 380798 outpatient prescriptions for diabetes were collected,including 273989 prescriptions“pre-policy”and 106809 prescriptions“post-policy”.The average age of the patients was(64.08±13.33)years,and the 60-79 years old patients accounted for 53.45%.Prescriptions for diabetes with complications accounted for 87.30%,with an average annual growth rate of 6.57%.Among all prescriptions,66867 prescriptions(17.56%)included insulin.One-way analysis showed statistically significant differences(P<0.05)in the logarithmic differences of prescription amounts among different time periods,genders,ages,types of diabetes,presence or absence of prescription included insulin,and the situation before and after the implementation of the National Centralized Drug Procurement Policy.Multiple linear regression analysis showed that time,gender,age,number of medication types,number of insulin types,and the implementation of the Policy were all influencing factors of medication costs(P<0.05).The prescription amounts each year were lower than those in 2019;the prescripti

关 键 词：糖尿病 集中带量采购 费用变化 影响因素 

分 类 号：R587.1[医药卫生—内分泌] R197.323[医药卫生—内科学]