摘要
目的通过分析甘肃省2017—2021年糖尿病患者住院费用构成及影响因素,为相关部门控制糖尿病住院费用提供参考。方法收集甘肃省2017—2021年全部主要出院诊断为糖尿病的患者住院费用信息,采用描述性分析、单因素分析、多重线性回归的方法分析住院费用的构成、变化趋势及影响因素。结果2017—2021年甘肃省糖尿病患者住院人次数年均增长率为10.58%,次均住院费用年均增长率为-2.38%,次均住院费用占比位于前三位的是诊断类费用(38.22%)、综合医疗服务类费用(28.81%)和西药费用(18.56%);多重线性回归分析显示,年龄(以<20岁为参照,20~39岁β=0.068,40~59岁β=0.208,60~79岁β=0.261,≥80岁β=0.126)、住院天数(以1~7天为参照,8~14天β=0.298,15~21天β=0.309,≥22天β=0.172)、婚姻状况(以未婚为参照,已婚β=-0.053,离婚β=-0.010,其他β=-0.082)、糖尿病类型(以1型糖尿病为参照,1型糖尿病伴有并发症β=0.037,2型糖尿病β=-0.047,2型糖尿病伴有并发症β=0.131)、出院年度(以2017年为参照,2018年β=-0.062,2019年β=-0.072,2020年β=-0.083,2021年β=-0.083)、医疗付款方式(以城镇职工基本医疗保险为参照,城镇居民基本医疗保险β=-0.111,全自费β=-0.009,其他β=-0.023)、医疗机构级别(以一级为参照,二级β=0.241,三级β=0.549)以及是否手术(β=-0.154)是糖尿病患者住院总费用的影响因素(P<0.05)。结论甘肃省糖尿病患者次均住院费用总体呈降低趋势,但需进一步优化费用结构,避免过度检查,合理缩短住院时间,加强基层管理服务,做好糖尿病的三级预防。
Objective To provide guidance for relevant departments to control hospitalization costs of diabetes by analyzing the composition and influencing factors of hospitalization costs of diabetic patients in Gansu Province from 2017—2021.Methods Information on hospitalization costs of all patients with major discharge diagnosis of diabetes in Gansu Province from 2017—2021 was collected,and the composition,trends and influencing factors of hospitalization costs were analyzed by descriptive analysis,univariate analysis and multiple linear regression.Results The annual average growth rate of the number of hospitalizations of diabetic patients in Gansu Province from 2017 to 2021 was 10.58%,the annual average growth rate of the average hospitalization costs was-2.38%,and the top three percentages of the average hospitalization costs were diagnostic costs(38.22%),comprehensive medical service costs(28.81%)and western medicine costs(18.56%).According to a multiple linear regression analysis,age(with 20 years as the reference,20-39 years β=0.068,40-59 years β=0.208,60-79 years β=0.261,≥80 yearsβ=0.126),hospitalization days(with 1-7 days as the reference,8-14 days β=0.298,15-21 daysβ=0.309,≥22 days β=0.172),marital status(with single as the reference,married β=-0.053,divorcedβ=-0.010,other β=-0.082),type of diabetes(with type 1 diabetes as the reference,type 1 diabetes with complicationsβ=0.037,type 2 diabetes β=-0.047,type 2 diabetes with complications β=0.131),discharge year(with 2017 as the reference,β=-0.062 in 2018,β=-0.072 in 2019,β=-0.083 in 2020,and β=-0.083 in 2021),medical payment methods(using urban employees’basic medical insurance as the reference,β=-0.111 for urban residents’basic medical insurance,β=-0.009 for all self-pay,and β=-0.023 for other),level of medical facility(using level 1 as the reference,level 2β=0.241,level 3β=0.549)and whether or not to operate(β=-0.154)were factors influencing the total hospitalization costs of diabetic patients(P<0.05).Conclusion The average hospitalization costs of diabetes in Gansu Province are decreasing,but there is a need to optimize the cost structure,avoid excessive examination,reasonably shorten the length of hospitalization,strengthen primary management services and the tertiary prevention of diabetes.
作者
吴君桐
何静
刘杰
陈永聪
马永恒
路杰
WU Ju-tong;HE Jing;LIU Jie;CHEN Yong-cong;MA Yong-heng;LU Jie(School of Public Health,Lanzhou University,Lanzhou,Gansu 730000,China;不详)
出处
《现代预防医学》
CAS
北大核心
2023年第16期3025-3030,3037,共7页
Modern Preventive Medicine
基金
国家第六批药物集中带量采购政策控费效果研究(横20220401)。
关键词
糖尿病
住院费用
变化趋势
影响因素
Diabetes
Hospitalization costs
Trends
Influencing factors
作者简介
吴君桐(1998-),女,硕士在读,研究方向:卫生事业管理、卫生费用研究;通信作者:路杰,E-mail:503287766@qq.com。
