甘肃省尘肺病患者直接医疗费用及其影响因素研究

Study on direct medical expenses and influencing factors of pneumoconiosis patients in Gansu province

目的掌握甘肃省尘肺病患者各年度直接医疗费用及其可能影响因素,为合理配置卫生资源、精准管理和施策提供科学依据。方法依托“甘肃省全民健康信息平台”,将2006-2020年甘肃省诊断的尘肺病病例数据,与平台信息匹配比对,筛出匹配病例2018-2020年因呼吸系统疾病门诊和住院就医费用支出信息,计算甘肃省尘肺病患者人均直接医疗费用。结果2018-2020年甘肃省尘肺病患者医疗总费用为563.183万元,人均直接医疗费用为0.386万元。尘肺病叁期、工龄为10~≤20年以及石棉肺患者人均直接医疗费用最高,分别为0.495、0.422、0.576万元。影响尘肺病患者人均直接医疗费用的因素有尘肺期别,工龄和病种。结论应在减轻尘肺病患者就诊经济负担的政策制定中考虑期别、病种等因素,加大对尘肺病叁期患者以及矽肺、石棉肺患者的医保报销比例。

Objective To master the annual direct medical expenses and possible influencing factors of pneumoconiosis patients in Gansu Province,and to provide a scientific basis for rational allocation of health resources,precise management and policy implementation.Methods Relying on the“National Health Information Platform of Gansu Province”,the data of pneumoconiosis cases diagnosed in Gansu Province from 2006 to 2020 were matched and compared with the platform information,and the matched cases were screened out from outpatient and inpatient with respiratory diseasesduring 2018 to 2020 for.Expenditures information was used to calculate the per capita direct medical expenses of pneumoconiosis patients in Gansu Province.Results From 2018 to 2020,the total medical cost of pneumoconiosis patients in Gansu Province was 5.63183 millionyuan,and the per capita direct medical cost was 3857.42 yuan.The third stage of pneumoconiosis,10-20 years of service,and asbestosis patients had the highest per capita direct medical expenses,which were 4954.80 yuan,4221.73 yuan and 5764.93 yuan,respectively.The factors affecting the per capita direct medical expenses of pneumoconiosis patients are:pneumoconiosis stage,length of service,and disease type.Conclusion It is suggested that factors such as stage and disease type should be considered in the formulation of policies to reduce the economic burden of pneumoconiosis patients,and the proportion of medical insurance reimbursement for patients with stage III pneumoconiosis and patients with silicosis and asbestosis should be increased.