摘要
目的了解广州市番禺区活动性肺结核患者门诊费用构成,为制定和完善结核病控制策略、优化资源配置提供依据。方法以2016—2018年在番禺区慢性病防治站登记管理并完成治疗的初、复治的所有活动性肺结核患者为研究对象,通过结核病管理信息系统、HISS系统、患者病案收集活动性肺结核患者的人口学特征、治疗分类、痰检结果、医疗保障方式等基本信息,计数资料采用均数、中位数表示,组间比较采用秩和检验(Mann-Whitney U)。结果共纳入1 723 例活动性肺结核患者,平均年龄为(36±16)岁,其中男性1 163例,女性560例;本地患者718例,占41.67%,外地患者1 005例,占 58.33%。调查对象的门诊直接医疗费中位数为 1 737.50元,其中人均检查费、检验费、药费和其他费用的中位数分别为88.32、333.88、1 124.21和131.99元。经两样本秩和检验发现,菌阳和菌阴患者、不同病灶范围患者、有医疗保障患者和无医疗保障患者、医改前和医改后患者之间直接医疗费用的差异均存在统计学意义(P<0.05),以菌阳患者、单发病灶患者、有医疗保障患者、医改后患者治疗费用高。结论不同类型患者的治疗费用存在差异,应当针对不同类型的患者有所倾斜,并加大经费投入、完善医疗保障政策。
Objective To understand the composition of outpatient expenses of active pulmonary tuberculosis patients in Panyu District, and provide a basis for formulating and improving tuberculosis control strategies and optimizing resource allocation. Methods All active tuberculosis patients treated for the first time or second time who were registered and managed by Panyu District Chronic Disease Prevention and Treatment Station and completed the treatment from 2016 to 2018 were considered as the research objects. Through the tuberculosis management information system, HISS system and medical records of patients, the demographic characteristics, treatment category, results of sputum examination, medical insurance method and other basic information of the active tuberculosis patients were collected. The count data was expressed with mean and median. For comparison among groups, the rank sum test (Mann-Whitney U) was used. Results A total of 1 723 patients with active tuberculosis were included, with an average age of (36 ± 16) years. Among them, 67.49%(1 163/1 723) were male and 33.51%(560/1 723) were female. Local patients accounted for 41.67%(718/1 723), and non-local patients accounted for 58.33%(1 005/1 723). The median of direct medical expenses of outpatient of the respondents was 1 737.50 yuan, among which the median of per capita examination fees, examination fees, drug fees and other expenses were 88.32 yuan, 333.88 yuan, 1 124.21 yuan and 131.99 yuan, respectively. After the rank sum test of two samples, it was found that the differences of direct medical expenses between bacterium positive and bacterium negative patients, patients with different lesion ranges, patients with medical insurance and patients without medical insurance, patients before medical reform and patients after medical reform had statistical significance (P < 0.05). The treatment costs of bacterium positive patients, patients with a single lesion and patients after medical reform were high. Conclusion There are differences in the treatment costs of different types of patients. We should give preference to different types of patients, increase funding, and improve medical security policies.
作者
赖静文
郭婉如
LAI Jingwen;GUO Wanru(Panyu District Chronic Disease Control Station,Guangzhou,Guangdong 511400,China)
出处
《中国热带医学》
CAS
2019年第7期659-661,666,共4页
China Tropical Medicine
基金
广州市科技计划项目(No.201707010431)
关键词
活动性结核
费用
痰检
病灶
Active tuberculosis
expenses
sputum examination
lesions
