上海市闵行区肺结核患者直接医疗费用及减免服务包扩展分析

发布时间：2018-01-22 20:52

  本文关键词： 肺结核 医疗费用 减免政策　出处：《复旦学报(医学版)》2017年05期 　论文类型：期刊论文

【摘要】：目的了解上海市闵行区肺结核患者确诊及治疗过程中的直接医疗费用及其对家庭造成的经济负担,为进一步完善肺结核减免政策,控制结核病医疗费用,减轻患者的经济负担提供依据。方法对本区347例完成治疗的肺结核患者进行发票的收集以及基本信息的问卷调查。用秩和检验分析不同类型肺结核患者的直接医疗费用;用多元线性回归分析直接医疗费用的影响因素;采用多个率的χ~2检验分析高额医疗费用与年龄、居民年人均可支配收入的关系。结果肺结核患者的直接医疗总费用为5 657元/人次。多元线性回归分析显示,直接医疗费用的影响因素有户籍、主要就诊机构以及有无合并症,其中主要就诊机构(β'=-0.217)对直接医疗费用影响较大。医疗费用扣除医保报销和结核病控制项目减免之后仍然有7.5%的患者产生高额医疗费用,并且在低收入人群中分布较多。结论肺结核确诊及治疗过程的直接医疗费用较高,给患者家庭造成了较严重的经济负担,应加强对老年、有合并症以及贫困群体的肺结核患者的医保报销和减免政策。
[Abstract]:Objective to understand the direct medical expenses and the economic burden on families during the diagnosis and treatment of pulmonary tuberculosis patients in Minhang District of Shanghai, so as to further improve the tuberculosis remission policy and control the tuberculosis medical expenses. Methods 347 patients with pulmonary tuberculosis completed treatment in our district were collected invoices and questionnaire survey of basic information. Rank sum test was used to analyze the patients with different types of pulmonary tuberculosis. Receiving medical expenses; Multiple linear regression analysis was used to analyze the influencing factors of direct medical expenses. The high medical cost and age were analyzed by 蠂 ~ 2 test with multiple rates. Results the total direct medical cost of pulmonary tuberculosis patients was 5 657 yuan / person-time. Multiple linear regression analysis showed that the influencing factors of direct medical expenses were household registration. Major medical institutions and complications. Major institutions (尾 -0.217). After deducting medical insurance reimbursement and TB control project relief, there are still 7.5% patients with high medical costs. Conclusion the direct medical cost of the diagnosis and treatment of pulmonary tuberculosis is higher, which has caused a serious economic burden to the patients' families, and should be strengthened to the elderly. Medical reimbursement and remission policies for tuberculosis patients with complications and poverty groups.
【作者单位】： 上海市闵行区疾病预防控制中心;复旦大学公共卫生学院流行病学教研室;
【基金】：上海市研究生教育创新计划 上海市公共卫生与预防医学Ⅰ类高峰学科建设计划~~
【分类号】：R521
【正文快照】： 中国是世界上22个结核病高负担国家之一,仅次于印度和印度尼西亚,位居全球第3位[1]。肺结核多发生在贫困人群,是导致我国贫困人群“因贫致病”和“因病返贫”的主要原因之一[2]。第5次结核病全国流行病学抽样调查显示,70%以上肺结核患者集中在中西部和农村地区,80%以上患者的

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