摘要
目的 调查社区高血压患者健康管理的药物治疗费用、住院费用及直接医疗费用的现状,为进一步评估国家基本公共卫生服务项目中的社区高血压患者健康管理是否具有卫生经济学上的成本效益奠定基础。方法 通过整群抽样的方法在5省10个调查点调查了8326例高血压患者,其中参与社区高血压患者健康管理1年以上的管理组对象3967例，未参与该管理的对照组4359例。通过问卷调查收集研究对象基本信息，并回顾型收集其在过去1年内（2009年11月至2010年11月）的医疗成本信息。分别对比分析两组患者的年度药物治疗费用、住院治疗费用和直接医疗费用。结果 高血压患者年均药物治疗费用为（621.50±1337.78）元，管理组为（616.13±1248.40）元，对照组为（626.44±1414.30）元。高血压服药患者年均药物治疗费用为（702.05±1401.79）元，管理组为（688.50±1300.70）元，对照组为（714.64±1489.60）元。城市高血压服药患者年均药物治疗费用【（731.88±1403.31）元】高于农村【（407.44±1171.44）元】。高血压患者的年住院率为12.2%（1014/8326），高血压住院患者年人均住院费用为（9264.47±18088.49）元，管理组【（7583.70±13267.00）元】低于对照组【（11028.00±21919.00）元】。高血压患者年人均住院费用为（1064.87±6804.83）元，管理组【（936.73 ±5284.90）元】低于对照组【（1181.50 ±7937.90）元】。高血压患者年人均直接医疗费用为（2275.08±8225.66）元，管理组为（2165.10±6564.60）元，对照组为（2375.20±9487.60）元；城市地区患者年人均直接医疗费用【（2801.06±9428.54）元】高于农村【（1254.70±4990.27）元】。结论 高血压社区健康或规范化管理能降低高血压服药患者年均药物治疗费用和患者年人均住院费用约6元和245元；节省高血压患者年人均直接医疗费用约210元。国家医疗卫生体制改革和发展中，应进一步加强和推广社区高血压患者健康或规范化管理。
Objective To investigate the current situation of drug cost, hospitalization cost and direct medical expense in community health management of hypertensive patients, in order to lay foundationfor evaluating whether the community health management in basic public health service has cost-effect in Health Economics.Methods 8326 hypertensive patients from 10 survey pilots in 5 provinces were selected by cluster sampling methods, including 3967 patients who took part in community health management for over 1 year as management group and 4359 cases who have never taken part in community health management as control group. The essential information of research objects were collected by questionnaire; and the medical cost information in the last year （from Nov. 2009 to Nov. 2010） were collected retrospectively. The different annual medical treatment cost, hospitalization cost and direct medical expense in the two groups were compared and analyzed. Results The average annual drug cost in hypertension was （621.50 ± 1337.78） yuan per patient; while the cost was （616.13±1248.40） yuan in management group and （626.44±1414.30） yuan in control group respectively. The average annual drug cost of hypertensive patients who toke medicine therapy was （702.05 ± 1401.79） yuan per person, while the cost in the management group （688.50±1300.70 yuan） was mcuh lower than it in control group （714.64±1489.60 yuan）. The annaul average drug cost in cities was （731.88±1403.31） yuan per person, which was higher than it in villages as （407.44±1171.44） yuan per person. The average hospitalized rate was 12.2% （1014/8326）, and the average annual cost among the hospitalized patients was （9264.47±18088.49） yuan per person; while the cost was （7583.70±13267.00） yuan in management group, which was lower than it in control group as （11028.00±21919.00） yuan. The average annual hospitalized cost in hypertensin was （1064.87±6804.83） yuan per person; while the cost was （936.73 ±5284.90） yuan in management group, which was lower than it in control group as （1181.50 ±7937.90） yuan. The average annual direct medical expense in hypersion was （2275.08±8225.66） per person; while the expense was （2165.10±6564.60） in management group and （2375.20±9487.60） in control group. The average annual direct medical expense in cities （2801.06±9428.54 yuan per person） was higher than it in villages （1254.70±4990.27 yuan per person）.Conclusion The community health or standardized managmentof hypertensive patients can reduce the average annual drug cost and hospitalization cost （ around 6 yuan and 245 yuan separately ）; and thereby save the annual direct medical expense per capita in hypertension （ around 210 yuan）. In the reform and development of national medical health system, we should enhance and promote the standardized community health management of hypertensive patients.
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2011年第8期732-736,共5页
Chinese Journal of Preventive Medicine
基金
国家“十一五”科技支撑计划（2006BAI01A01）
关键词
高血压
医院
社区
公共卫生管理
成本效益分析
Hypertension；Hospitals, community；Public health Administration；Cost-benefit analysis
