某市2001年1月至2016年10月精神疾病患者基本情况与住院费用影响因素分析

发布时间：2018-05-13 19:31

本文选题：精神疾病 + 医疗费用　；参考：《大连医科大学》2017年硕士论文

【摘要】：目的:精神疾病的高发率与低治愈率给社会带来了沉重的危害,了解精神疾病患者的基本情况,对精神卫生服务的实施至关重要,精神疾病负担的评估对精神卫生决策也具有重要作用,对精神疾病患者住院费用进行总体评价、分析其影响因素,可以为制定精神卫生的相关政策提供科学的参考依据。方法:采用横断面及回顾式研究方法,应用SAS 9.1和SPSS 23.0软件处理分析2001年至2016年10月某市某精神疾病专科医院收治住院的各类精神疾病患者的基线资料和医疗费用数据,描述精神疾病患者人数的分布特征,应用t检验和方差分析等对患者住院费用进行统计检验,利用多重线性回归分析该市精神疾病患者住院费用的影响因素。结果:1.该精神疾病专科医院自2001年1月起至2016年10月止共收治各类精神疾病患者26151例住院,119056人次,其中男性患者9864例,41460人次,女性患者16287例,77569人次。女性患者入院人数与住院人次均大于男性。2.各病种住院病例数前五位分别是抑郁发作、精神分裂症、其他焦虑障碍、分离(转换)性障碍和复发性抑郁障碍;住院人次前五位疾病分别为复发性抑郁障碍、精神分裂症、其他焦虑障碍、抑郁发作、双相情感障碍。3.从2013年起,住院病例最多的抑郁发作患者人数持续下降,精神分裂症患者人数自2007年起逐步下降,复发性抑郁障碍人数则在2012年起持续攀升,分离(转换)性障碍患者人数波动不明显,其他焦虑障碍患者人数在2008年后略有上升。从2001年开始男女住院人次数几乎逐年递增,男性和女性分别在2013年和2014年达到住院人次高峰。4.住院天数、付费方式和入院次数是影响大部分精神疾病患者医疗费用的主要影响因素。结论:自2001年以来,抑郁发作患者人数为6661人,是患者人数最多的精神疾病,复发性抑郁障碍累计就诊37888人次,总医疗费用19509.7万元,是就诊人次和医疗费用最多的精神疾病,次均医疗费用最高为精神分裂症6139元,从疾病负担角度看,抑郁障碍与精神分裂症是该市最值得患者的精神疾病之一。精神疾病患者医疗费用的主要影响因素包括社会因素(性别、婚姻状况和职业因素)与临床因素(住院天数与入院次数),而临床因素缩短、加大入院间隔应当成为降低疾病直接医疗费用的突破口。
[Abstract]:Objective: the high incidence rate and low cure rate of mental illness have brought heavy harm to the society. It is very important for the implementation of mental health service to understand the basic situation of patients with mental illness. The assessment of mental disease burden also plays an important role in mental health decision-making. The overall evaluation of hospitalization expenses of mental illness patients and the analysis of its influencing factors can provide a scientific reference for the formulation of mental health related policies. Methods: SAS 9.1 and SPSS 23.0 software were used to process and analyze the baseline data and medical cost data of all kinds of mental illness patients admitted to a special hospital of mental illness in a certain city from 2001 to 2016 by using cross-sectional and retrospective study methods. This paper describes the distribution characteristics of the number of patients with mental illness, uses t test and variance analysis to test the hospitalization expenses of the patients, and makes use of multiple linear regression analysis to analyze the influencing factors of the hospitalization expenses of the patients with mental illness in the city. The result is 1: 1. From January 2001 to October 2016, a total of 26151 patients with various mental diseases were admitted to the hospital, including 9864 male patients and 16287 female patients. The number of female patients admitted and the number of hospitalizations were higher than that of men. The first five inpatients of each kind of disease were depression attack, schizophrenia, other anxiety disorder, separation (conversion) disorder and recurrent depressive disorder, and the first five diseases in hospital were respectively recurrent depressive disorder and schizophrenia. Other anxiety disorders, depression, bipolar disorder. 3. Since 2013, the number of the most hospitalized depressive episode patients has continued to decline, the number of schizophrenia patients has been declining since 2007, and the number of recurrent depressive disorders has continued to rise since 2012. There was no significant change in the number of patients with dissociative disorder, while the number of other anxiety disorders increased slightly after 2008. Since 2001, the number of hospitalizations of both sexes has increased year by year, with male and female hospitalizations reaching a peak of 0.4 in 2013 and 2014, respectively. The days of hospitalization, the way of payment and the times of admission are the main factors that affect the medical expenses of most mental patients. Conclusion: since 2001, the number of depressive attack patients is 6661, which is the largest number of patients with mental illness. The total medical cost of recurrent depressive disorder is 37888, and the total medical cost is 195.097 million yuan, which is the most expensive mental illness. The highest average medical cost was 6139 yuan for schizophrenia. From the point of view of disease burden, depressive disorder and schizophrenia are one of the most worthy mental diseases in the city. The main factors influencing the medical expenses of patients with mental illness included social factors (sex, marital status and occupation factors) and clinical factors (length of stay and times of admission), while clinical factors were shortened. Increasing the interval of admission should be a breakthrough in reducing the direct medical cost of the disease.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749;R197.323

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