四川省糖尿病疾病经济负担及影响因素分析
|
摘要
目的:研究四川省糖尿病经济负担及其影响因素,为糖尿病防控工作提供参考。方法:通过分层整群抽样收集资料,对四川省糖尿病患者直接经济负担和间接经济负担进行测算,利用多元对数线性回归模型进行直接经济负担的影响因素分析。结果:2014年四川省糖尿病疾病经济负担为70.6亿元(直接经济负担60.1亿元,间接经济负担10.5亿元),占四川省GDP的0.25%;门诊次均费用(369.9元)主要受药占比、机构级别、机构类别等因素影响,住院次均费用(7 671.7元)主要受机构级别、有无并发症、年龄等因素影响。结论:四川省糖尿病门诊经济负担高于住院,药占比较高,参保人员费用意识不强,迫切需要建立广泛的社区慢性病防治网络,加强医院内部管理,加大医保监管力度。
Objective To study the economic burden of diabetes and its influencing factors in Sichuan Province, and to provide reference for diabetes prevention and control work. Methods Through the stratified cluster sampling data collection,the direct economic burden and indirect economic burden of diabetic patients in Sichuan Province were measured. The multivariate log-linear regression model was used to analyze the influencing factors of direct economic burden. Results The economic burden of diabetes in Sichuan Province in 2007 was 7.06 billion yuan(direct economic burden was 6.01 billion yuan,indirect economic burden was 1.05 billion yuan),accounting for0.25% of Sichuan's GDP. The average cost of outpatient services(369.9 yuan) was mainly affected by factors such as the proportion of drugs,institutional level,and institutional category. The average cost of hospitalization(7671.7 yuan) was mainly affected by factors such as institutional level,complications and age. Conclusion The economic burden of diabetes clinics in Sichuan Province was higher than that of hospitalization. The drug occupation was relatively high,and the awareness of the cost of insured personnel was not strong. It is urgent to establish a wide network of community chronic disease prevention and control,strengthen the internal management of hospitals,and strengthen the supervision of medical insurance.
Objective To study the economic burden of diabetes and its influencing factors in Sichuan Province, and to provide reference for diabetes prevention and control work. Methods Through the stratified cluster sampling data collection,the direct economic burden and indirect economic burden of diabetic patients in Sichuan Province were measured. The multivariate log-linear regression model was used to analyze the influencing factors of direct economic burden. Results The economic burden of diabetes in Sichuan Province in 2007 was 7.06 billion yuan(direct economic burden was 6.01 billion yuan,indirect economic burden was 1.05 billion yuan),accounting for0.25% of Sichuan's GDP. The average cost of outpatient services(369.9 yuan) was mainly affected by factors such as the proportion of drugs,institutional level,and institutional category. The average cost of hospitalization(7671.7 yuan) was mainly affected by factors such as institutional level,complications and age. Conclusion The economic burden of diabetes clinics in Sichuan Province was higher than that of hospitalization. The drug occupation was relatively high,and the awareness of the cost of insured personnel was not strong. It is urgent to establish a wide network of community chronic disease prevention and control,strengthen the internal management of hospitals,and strengthen the supervision of medical insurance.
引文
[1]中国2型糖尿病防治指南(2013年版)[J].中国糖尿病杂志2014,22(8):2-42.
[2]佚名.世界卫生组织发布《全球糖尿病报告》[J].中国卫生政策研究,2016(4):61.
[3]中华人民共和国卫生和计划生育委员会.中国居民营养与慢性病状况报告(2015年)[EB/OL].http://www.nhfpc.gov.cn/zwgk/jdjd/201506/4505528e65f3460fb88685081ff158a2.shtml.
[4]四川省卫生和计划生育委员会.2014年四川省人群健康状况及重点疾病报告[EB/OL].http://www.sc.gov.cn/10462/10705/10708/2015/6/9/10338827.shTml.
[5]中华人民共和国卫生和计划生育委员会统计信息中心.第五次国家卫生服务调查分析报告[M].北京:中国协和医科大学出版社,2015.
[6]四川省卫生和计划生育委员会.四川卫生和计划生育统计年鉴2014[M].成都:西南交通大学出版社,2015.
[7]杨菊,张开金,蒋丽琴,等.苏南农村社区居民常见慢性病疾病经济负担调查[J].中国全科医学,2013(1):82-84.
[8]郭振友,石武祥,马明霞,等.桂林市居民高血压糖尿病患病情况与疾病经济负担研究[J].中华疾病控制杂志,2015(9):887-889,893.
[9]张艳,王玲,王涛,等.山东省淄博市手足口病经济负担调查分析[J].卫生经济研究,2016(2):47-49.
[10]王明慧,曹乾,陆广春.医保与非医保患者住院费用比较及其影响因素分析[J].中国卫生经济,2009,28(1):35-38.
[11]杨玉婷,赵蓉,项耀钧.上海医保总额预付制对医院服务效率和费用的影响研究[J].中华医院管理杂志,2015,31(4):271-274.
[12]何克春,苏明丽,袁红梅.定点医院推行医保体系化管理初探[J].医学与社会,2012,25(6):55-57.
[2]佚名.世界卫生组织发布《全球糖尿病报告》[J].中国卫生政策研究,2016(4):61.
[3]中华人民共和国卫生和计划生育委员会.中国居民营养与慢性病状况报告(2015年)[EB/OL].http://www.nhfpc.gov.cn/zwgk/jdjd/201506/4505528e65f3460fb88685081ff158a2.shtml.
[4]四川省卫生和计划生育委员会.2014年四川省人群健康状况及重点疾病报告[EB/OL].http://www.sc.gov.cn/10462/10705/10708/2015/6/9/10338827.shTml.
[5]中华人民共和国卫生和计划生育委员会统计信息中心.第五次国家卫生服务调查分析报告[M].北京:中国协和医科大学出版社,2015.
[6]四川省卫生和计划生育委员会.四川卫生和计划生育统计年鉴2014[M].成都:西南交通大学出版社,2015.
[7]杨菊,张开金,蒋丽琴,等.苏南农村社区居民常见慢性病疾病经济负担调查[J].中国全科医学,2013(1):82-84.
[8]郭振友,石武祥,马明霞,等.桂林市居民高血压糖尿病患病情况与疾病经济负担研究[J].中华疾病控制杂志,2015(9):887-889,893.
[9]张艳,王玲,王涛,等.山东省淄博市手足口病经济负担调查分析[J].卫生经济研究,2016(2):47-49.
[10]王明慧,曹乾,陆广春.医保与非医保患者住院费用比较及其影响因素分析[J].中国卫生经济,2009,28(1):35-38.
[11]杨玉婷,赵蓉,项耀钧.上海医保总额预付制对医院服务效率和费用的影响研究[J].中华医院管理杂志,2015,31(4):271-274.
[12]何克春,苏明丽,袁红梅.定点医院推行医保体系化管理初探[J].医学与社会,2012,25(6):55-57.