上海市肺结核病患者直接医疗费用及构成分析

Analysis on direct medical expenditure and its constitution of pulmonary tuberculosis patients in Shanghai

目的:了解上海市肺结核患者确诊前后的直接医疗费用及构成,为制定和完善结核病控制政策、优化资源配置提供依据。方法:对7个区共714位完成治疗的肺结核病患者进行定量问卷调查,同时每个区选2～3名患者进行定性访谈。结果:肺结核病患者确诊前直接医疗费用均数为2 728.8元,中位数为500元,不同类型患者间无统计学差异;确诊及治疗过程,直接医疗费用均数为8 792.4元,中位数为4 000元,本地和外地患者、初治和复治患者的门诊费用差异有统计学意义。结论:上海市肺结核病患者的直接医疗费用在确诊前较低,确诊及治疗过程中医疗费用较其他地区偏高;治疗过程中辅助药物和检查应用比例较高。

Objective： To understand the direct medical costs and constitution before and after diagnosis of pulmonary tuberculosis（TB） patients in Shanghai in order to provide evidence for better improving and optimizing the allocation of resources. Methods： Seven hundred and fourteen pulmonary TB patients who had completed treatment from 7 districts of Shanghai were investigated by questionnaire and 2 - 3 patients in each district were interviewed. Results： Before confirmed diagnosis, the mean and median medical expenditure of TB patients were 2 728.8 yuan and 500 yuan respectively. There were no statistical differences among various types of patients. During the process of confirmed diagnosis and treatment, the mean and median medical expenditure were 8 792.4 yuan and 4 000 yuan. The outpatient cost between the local and migrant patients and between initial and retreatment patients were definitely different based on the statistic outcomes. Conclusion： The direct medical cost before confirmed diagnosis of pulmonary TB patients in Shanghai was lower. However, the diagnosis and treatment costs were higher compared to other regions. Supportive drug and examination accounted for higher proportion during the process of treatment.