乙肝相关疾病患者3294例住院费用分析

Hospitalization expenditure of 3294 patients with chronic hepatitis B related diseases

目的探讨乙肝相关疾病住院医疗费用的影响因素,为完善医疗保障制度和制定乙肝相关疾病防治规划提供依据。方法对山西省某综合医院2002-2009年3 294例乙肝相关疾病住院患者的住院费用进行主成分分析,采用COX回归法分析影响乙肝相关疾病住院费用的因素。结果 2002-2009年该院乙肝相关疾病患者逐年增加,平均年龄为(46.55±13.93)岁,60.02%的患者为农民,平均住院天数为16 d;住院费用的主要影响因素依次为:付费方式、入院情况、出入院诊断是否一致、有无次要诊断、乙肝表向抗原情况、住院天数、药品比例、年龄,住院费用随这些因素的增加而升高(P<0.01),公费患者高于自费患者的花费。结论加强对药品费用的控制管理和缩短住院天数是目前降低乙肝相关疾病住院费用的有效可行手段。

Objective To investigate the influencing factors of hospitalization expenditure among patients with chronic hepatitis B（CHB） related diseases,and to provide evidence for the improvement of medicine security system and CHB prevention.Methods The medical records of patients with CHB related diseases in general hospital of Shanxi province from 2002 to 2009 were collected.Principal component analysis and multivariate Cox regression model were applied in the analysis.Results From 2002 to 2009,the number of inpatients with CHB related diseases increased yearly.The average age of the inpatients was 46.5±13.93 years and 60.02 percent of the patients were farmers.The average time of hospitalization was 16 days.The significant influencing factors of the hospitalization expenditure included admission state,secondary diagnosis,hospitalization days,status of HBsAg,proportion of medicine cost,and age（P0.01 for all）.Conclusion The economic burden of patients with CHB related diseases were heavier.We should strengthen hospital management and establish clinical practice guideline and criteria for the control of proportion of medicine cost and days of hospitalization to decrease the economic burden of the patients.