上海市半淞园地段医院高血压患者门诊费用分析

陈延; 王梅; 詹思延; 刘克军; 孙琪; 陈玮华; 戴立强; 任涛; 吴涛; 李俊; 秦颖; 曹卫华; 胡永华

Abstract

陈延,王梅,詹思延,刘克军,孙琪,陈玮华,戴立强,任涛,吴涛,李俊,秦颖,曹卫华,胡永华.上海市半淞园地段医院高血压患者门诊费用分析[J].Chinese journal of Epidemiology,2003,24(12):1074-1077

上海市半淞园地段医院高血压患者门诊费用分析

An analysis on the cost of hypertensive outpatient in the community hospital in Shanghai

Received:August 27, 2003

DOI：

KeyWord: 高血压门诊费用社区

English Key Word: Hy pertension Expenditure of outpatient Community

FundProject:国家“十五”科技攻关课题资助项目 (2001BA703B02 )

Author Name	Affiliation
Chen Yan	The School of Public Health, Peking University, Beijing 100083, China
Wang Mei	卫生部卫生经济研究所
Zhan Siyan	The School of Public Health, Peking University, Beijing 100083, China
Liu Kejun	卫生部卫生经济研究所
Sun Qi	上海市黄浦区半淞园地段医院
Chen Weihua	上海市黄浦区半淞园地段医院
Dai Liqiang	上海市黄浦区半淞园地段医院
Ren Tao	The School of Public Health, Peking University, Beijing 100083, China
Wu Tao	The School of Public Health, Peking University, Beijing 100083, China
Li Jun	The School of Public Health, Peking University, Beijing 100083, China
Qin Ying	The School of Public Health, Peking University, Beijing 100083, China
Cao Weihua	The School of Public Health, Peking University, Beijing 100083, China
Hu Yonghua	The School of Public Health, Peking University, Beijing 100083, China

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Abstract:

目的了解和分析某社区高血压患者门诊费用情况,并对社区心脑血管疾病综合防治模式进行卫生经济学评价。方法选取实施现场的某社区中 460名参保高血压患者,通过医院的医保结算系统,逐次追踪调查了其 2002年一年的门诊费用情况,并进行统计学分析。结果高血压患者的年门诊费用情况呈正偏态分布,总体上各年龄组的费用水平随着患者年龄的增加而逐渐升高。年门诊费用的中位数为 15 6 7.9元,年人均门诊次数 19.5次,次均费用 115.4元。在 40～岁和 50～岁两年龄组中,不同性别间的年门诊费用 (WilcoxonW_{40～ 49}=36,P_{40～ 49}=0.037;WilcoxonW50～ 59=374,P50～ 59=0.023)和年门诊次数比较 (WilcoxonW40～ 49=5 2.5,P_{50～ 59}=0.007;WilcoxonW_{50～ 59}=379,P_{50～ 59}=0.028)差异有显著性,女性明显高于男性。同时考虑到性别和年龄因素时,男性各年龄组的年门诊费用(χ²=22.3,P<0.00 1)和年门诊次数的比较 (χ²=25.4,P<0.001)差异也存在显著性。此外,在年门诊总费用中,药品费用占 83.6% ;而在药品费用中,高血压直接、相关以及无关费用分别占 19.9%、32.3%和 47.8%。结论为合理测算社区高血压人群干预的成本和效益提供了基本可靠的依据 ;同时从侧面反映出政

English Abstract:

Objective To study the cost of the hy pertensive outpa tients.Methods The study randomly selected 460 insured patients w ith hypertension and investigated their cost on each case in the outpatient department throug h 2002, based on the electronic system of medical insurance.Results As aw ho le, the distribution of hy pertensive outpatient ex penditure takes on the positively skewed, with the median of 1567.9 Yuan RMB.With the increase of age, the average expenses in each age group increased accordingly.In the study, the average number of outpa tient a ttendances per patient was 19.5, the average expenses per visit w as 115.4 Yuan RMB.I n age g roups 40-49 and 50-59, expenses of outpatient in male and female groups are obviously different in 2002 (Wilco xon W_40-49=36, P_40-49= 0.037 ;Wilco xonW_50-4\59=374, P_50-4\59=0.023), as well as the number of out-patients (Wilcox on W_40-49=52.5, P_40-49=0.007 ;Wilco xon W_50-4\59=379, P_50-4\59=0.028).When considering the facto rs of gender and age at onetime, the outpatient expenditures in the male group w ere sig nificantly different be tw een the different age groups (χ²=22.3, P <0.001), as well as the number of outpatients (χχ²=25.4, P <0.001).In additin, the expenditure of drugs, which took a large propor tion of the total expenditure of hy pertensive outpatients (about 83.6 percent), w as divided into three parts according to the degree o f cor rela tio n withhypertension :direct ex penses related to the with disease, the indirect ex penses and the irrespective.The propo rtions of each part were 19.9 percent, 32.3 percent and 47.8 percent respectively.Conclusion When economic evaluatio n of community preventio n is carried out, the cost and cost-benefit analysis based on the analy sis of outpatient expenditure and the propo rtion of expenses on hypertension should be taken into account.Additionally, to provide appropriate mode of medicare, to impact the behaviors and expenditure o f patients, and to provide low-cost but good effective drug are also essential and important factors.

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