新疆某三甲医院0-18岁因伤害住院患者疾病经济负担及灾难性医疗支出研究  

Study on the Economic Burden of Diseases and Catastrophic Medical Expenditures for Inpatients Aged 0-18 Due to Injuries in a Tertiary Grade A Hospital in Xinjiang

作　　者：权晓雯 杨圆圆[2] 张晓洁[3] 杨佳睿 霞依丹·阿不都色米 方娴[1] QUAN Xiaowen(School of Public Health,Xinjiang Medical University,Urumqi,Xinjiang,830011,China)

机构地区：[1]新疆医科大学公共卫生学院,新疆乌鲁木齐830011 [2]新疆医科大学第一附属医院医务管理科,新疆乌鲁木齐830011 [3]新疆医科大学附属肿瘤医院质量管理科,新疆乌鲁木齐830011

出　　处：《医学与社会》2024年第12期60-68,共9页Medicine and Society

基　　金：新疆维吾尔自治区自然科学基金资助项目,编号为2020D01C164。

摘　　要：目的:分析新疆某三甲医院0-18岁因伤害住院患者的疾病经济负担及灾难性医疗支出,为减轻患者疾病经济负担提供参考。方法:对2021年1月-2023年10月在新疆某三甲医院因伤害住院的0-18岁患者进行问卷调查,分析疾病经济负担并计算灾难性医疗支出,利用分位数回归模型对发生灾难性医疗支出的患者家庭进行影响因素分析。结果:共纳入0-18岁因伤害住院患者1373例,疾病经济负担总计2873.5万元;排前3位的伤害原因分别为跌倒/坠落、机动车车祸及烧烫伤;当疾病经济负担占家庭年收入40%及以上时,有49.9%的患者家庭发生灾难性医疗支出;在不同灾难性医疗支出标准(40%、30%、20%、10%)下,患者的入学情况、父母学历、父母职业、家庭月收入、家里小孩数目、伤害原因、伤害性质、伤害部位、残疾程度、住院日及后遗症等因素,分别对患者疾病经济负担产生不同程度的影响作用。结论:新疆某三甲医院0-18岁因伤害住院患者的疾病经济负担较重,发生灾难性医疗支出的概率较高。应根据不同伤害类型制定针对性的防控政策,对伤害进行分级分类管理,减轻患者疾病经济负担。Objective:To analyze the economic burden of diseases and catastrophic medical expenditures for inpatients aged 0-18 due to injuries at a tertiary Grade A hospital in Xinjiang,so as to provide a reference for reducing patients'financial burden.Methods:A questionnaire survey was conducted on inpatients aged 0-18 who were hospitalized for injuries at a tertiary Grade A hospital in Xinjiang from January 2021 to October 2023.The economic burden of diseases was analyzed,and catastrophic medical expenditures were calculated.A quantile regression model was used to analyze the influencing factors for families incurring catastrophic medical expenditures.Results:A total of 1373 inpatients aged 0-18 were included,with a total economic burden of 28.735 million yuan.The top three causes of injury were falls,motor vehicle accidents,and burns/scalds.When the economic burden of diseases accounted for 40%or more of the household's annual income,49.9%of families experienced catastrophic medical expenditures.Factors such as patient enrollment,parents'educational background,parents'occupation,monthly household income,number of children,cause of injury,nature of injury,site of injury,degree of disability,length of hospital stay,and sequelae all had varying degrees of impact on the economic burden under different catastrophic medical expenditure thresholds(40%,30%,20%,10%).Conclusion:The economic burden of diseases for inpatients aged 0-18 due to injuries at a tertiary Grade A hospital in Xinjiang is heavy,with a high probability of catastrophic medical expenditures.Targeted prevention and control policies should be developed according to different types of injuries,with graded and categorized management to reduce the economic burden of disease on patients.

关 键 词：疾病经济负担 灾难性医疗支出 伤害 三甲医院 

分 类 号：R-05[医药卫生] R197