摘要
目的:掌握衢州市肺结核住院病人住院及住院费用情况,为今后规范诊疗行为提供依据。方法:采用整群抽样方法确定调查对象,对全市各结核病定点医院的总住院率和住院病人费用进行调查,运用描述流行病学方法,分析各医院的住院率、住院病人费用构成及不同人群的费用情况。结果:2005年1-7月,各定点医院共初诊肺结核2 162例,发现活动性肺结核1 601例,涂阳524例。收治入院508例,住院率31.73%,其中154例为单纯肺结核病例,占30.31%。抽样调查290例住院病例,例均住院9天;例总费用最低368.34元,最高35 076.5元,例均总费用3 899.21元,日均费用433.25元;例均药费1 928.67元、占总费用的49.46%;住院病人平均年龄58.43岁,以农民为主,占81.91%,农民例均药费1 627.37元,例均费用最高的是离退休者,达6 392.10元,是农民的1.8倍;医疗费用越有保障,住院费用越高,而是否有并发症,费用变化不大。结论:由综合性医院定点诊治肺结核确实存在较高的住院率;患者的社会身份,经济状况和不合适的治疗方法决定了的患者住院费用的高低;高住院率、高住院费用增加了患者的负担,也不符合结核病治疗原则;综合性医院定点诊治肺结核病这一防治模式,存在较大缺陷。
Objective To analyze the status of tuberculosis inpatients and the correspondingly medical expense in order to provide the reference for tuberculosis treatment policy. Method Our subjects were chosen by cluster sampling. We use descriptive method to analyze the rate of hospitalization in different medical institution, the structure of medical expense and the expenses of different groups. Result From January to July in 2005, the newly registered TB cases in the assigned tuberculosis department in the general hospital were 2162, the newly registered active TB cases were 1601, and the smear-positive patients were 524. Moreover 608 of them were admitted in hospital, the rate of hospitalization was 31.73%, of which 154 diagnosed as TB with none complications, accounting for 30.31%. We collected successively 290 cases by the record of their hospitalization, the median of their stay in hospital were 9, the medical expense ranged from 368. 34 yuan-35076. 5 yuan, the average of total expense,drugs were 3899. 21 yuan, 1928. 67 yuan respectively. And averagely charged 433. 25 yuan of each day; besides, the average age of all inpatients were 58.43, and most of them were farmers, taking up 81.91% of aZl cases. The average expenses of each farmers were 1627.37 yuan, but the highest average charges were 6392.10 yuan paid by retiree, which was 1.8 times more than that of farmers＇. From this survey, we found that the patients who subscribed to China urban employee＇ s basic health insurance will pay more expenses, but it showed no difference between the inpatients with complications and those with none. Conclusion There actually exist the high rate of the hospitalization of TB cases. The social status,the way of treatment could determine the expenses they paid. Also the high expenses and the high rate of hospitalizations increased the economical burden of the patients. The mode of assigned tuherculosis department in the general hospital should be improved and it must be regulated under the government.
出处
《中国农村卫生事业管理》
2006年第12期41-44,共4页
Chinese Rural Health Service Administration
关键词
肺结核病
住院费用
流行病学调查
Tuberculosis
medical expense
epidemiological investigation
