新疆生产建设兵团包虫病患者住院费用及影响因素分析

发布时间：2018-04-22 07:21

本文选题：包虫病 + 住院费用　；参考：《石河子大学》2013年硕士论文

【摘要】：目的：调查2007-2011年新疆生产建设兵团包虫病住院病人的一般信息与费用资料，分析兵团包虫病住院医疗费用现状，探讨其主要影响因素，为卫生决策者提供参考依据。方法：本研究收集新疆生产建设兵团2007-2011年一家三级医院与六家二级医院包虫病患者病例首页资料及住院医疗费用信息，用Excel2007建立数据库及校对，利用SPSS17.0软件对数据进行统计描述，采用非参秩和检验对影响因素进行单因素分析，采用多元逐步回归方法对影响因素进行多因素分析，评价各因素对包虫病住院费用的影响及控制对策。结果： 1.新疆生产建设兵团2007-2011年七家师医院共收治529例住院病人。年龄从7岁到88岁不等，其中以30~45岁居多；民族以汉族为主，占81%；职业以农牧民为主；农村患者多于城镇患者，，依次占59.36%和40.64%；自费患者比例高于医保患者，各占82.4%和17.5%；住院天数集中在10~19天，平均住院日为19天；三级医院平均住院日为18天，二级医院为20天；治愈与好转患者手术率为87.8%（389/443）。 2.人均住院费用从2007年的12191.89元上升到2011年的19154.48元；其中汉族16233.90元，排名第一，其次为回族15059.29元；职业中以干部位居第一18031.87元；城镇与农村患者相近，依次为15867.80元和15844.25元；自费患者高于医保患者为15305.59元和14033.68元；手术患者远高于非手术患者依次为19239.53元与5713.57元；三级医院高于二级医院患者为15565.65元与10872.70元。 3.本研究中对包虫病住院费用的分析重点选择了住院总费用中的药品费、治疗费、检查费、手术费、床位费和其它费用作为分析指标。其中药品费用均数最高，为5520.2元，其次为检查费用2420.6元；除治疗费用以外，其他费用三级医院均高于二级医院。 4.经单因素与多因素分析结果显示，包虫病住院费用的影响因素是多方面的，住院天数、出院情况、住院年份、年龄、负担方式、民族、居住地是住院费用的主要影响因素。结论： 1.尽管国家加大了对包虫病手术患者的补助，但随着近年来住院费用的不断上涨，新疆生产建设兵团包虫病患者个人仍需承担较高的费用。 2.从住院费用支付形式来看，新疆生产建设兵团包虫病患者参加医疗保险补助体系的比例仍然很低。 3.从医院级别来看，新疆生产建设兵团三级医院包虫病患者住院人数与住院费用均高于二级医院，但三级医院的包虫病患者住院人数呈现逐年递减趋势。 4.药品费、检查费在新疆生产建设兵团包虫病患者住院费用中用占有较大比例，而且仍然存在增长过快现象。
[Abstract]:Objective: To investigate the general information and cost data of hospitalized patients with hydatid disease in Xinjiang production and Construction Corps from 2007 to 2011, to analyze the present situation of hospitalization medical expenses of echinococcosis in Xinjiang production and Construction Corps, to discuss the main influencing factors, and to provide reference basis for health decision makers. Methods: This study collected the data of the first page of cases of hydatid disease in a third class hospital and six level II hospitals of Xinjiang production and Construction Corps from 2007 to 2011, and used Excel2007 to set up a database and proofread the data, and to use SPSS17.0 software to carry on the statistical description to the data. Non-parametric rank sum test was used to analyze the influencing factors and multivariate stepwise regression was used to analyze the influencing factors to evaluate the influence of various factors on the hospitalization expenses of hydatid disease and the control measures. Results: 1. Xinjiang production and Construction Corps in 2007-2011 seven division hospitals a total of 529 hospitalized patients. The ages ranged from 7 to 88 years, of which 300-45 years were the majority; ethnic groups were the Han nationality, accounting for 81%; the occupation was mainly farmers and herdsmen; rural patients were more than urban patients, accounting for 59.36% and 40.64%, respectively; and the proportion of self-funded patients was higher than that of medical insurance patients. The average hospitalization days were 1019 days, 18 days in the third class hospital and 20 days in the second class hospital, and the operative rate of the cured and improved patients was 87.8%. 2. The cost of hospitalization per capita increased from 12191.89 yuan in 2007 to 19154.48 yuan in 2011, including 16233.90 yuan for Han nationality, the first for Han nationality, 15059.29 yuan for Hui nationality, 18031.87 yuan for cadres, 15867.80 yuan for urban patients and 15844.25 yuan for rural patients. The self-funded patients were 15305.59 yuan and 14033.68 yuan higher than the medical insurance patients; the operation patients were 19239.53 yuan and 5713.57 yuan respectively higher than the non-operative patients; the third class hospitals were 15565.65 yuan and 10872.70 yuan higher than the second-class hospitals. 3. In this study, the cost of hospitalization for hydatidosis was analyzed by selecting the total cost of drugs, treatment, examination, operation, bed and other expenses as the analysis index. The average cost of drugs is the highest, which is 5520.2 yuan, followed by 2420.6 yuan of inspection expenses, except for the treatment expenses, the other three level hospitals are all higher than the second class hospitals. 4. The results of univariate and multivariate analysis showed that there were many factors affecting the hospitalization cost of hydatid disease. The days of hospitalization, discharge, year of hospitalization, age, burden mode, nationality and residence were the main factors affecting the cost of hospitalization. Conclusion: 1. Although the state has increased the subsidies for patients undergoing echinococcosis surgery, with the increasing cost of hospitalization in recent years, individuals of echinococcosis patients in Xinjiang production and Construction Corps still have to bear higher costs. 2. The proportion of patients with hydatid disease in Xinjiang production and Construction Corps is still very low. 3. From the hospital level, the number and expense of patients with hydatid disease in the third level hospital of Xinjiang production and Construction Corps were higher than those of the second class hospital, but the number of patients with hydatid disease in the third level hospital showed a decreasing trend year by year. 4. In Xinjiang production and Construction Corps, the cost of medicine and examination accounts for a large proportion of the cost of hospitalization of patients with hydatid disease, and there is still a phenomenon of excessive growth.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R825.3

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