类风湿性关节炎患者医疗费用影响因素研究

Study on The Influence factors of The Medical Expenses of Patients with Rheumatoid Arthritis

目的探讨类风湿性关节炎医疗费用的影响因素,为相关部门推行单病种付费标准提供政策性参考依据。方法以广州市医疗保险数据库中2007-2011年29431例类风湿性关节炎患者的医疗费用数据为研究内容,采用了非参数检验、逐步回归分析等方法进行统计学分析。结果患者的年龄、性别、医保类型、就诊医疗机构均对医疗费用产生影响,差别具有统计学意义。门诊患者药费占费用总支出的75.29%,住院患者药费占总费用的44.99%;多元线性回归中,无论门诊患者还是住院患者,变量X5(就诊医院级别)的标准化回归系数显著高于其他变量的标准化回归系数,分别为0.168和0.238,说明药费和就诊医院级别是影响患者医疗费用的主要因素。结论完善医保付费制度和卫生资源配置,将类风湿性关节炎治疗药品纳入医保药品目录,可以减轻患者疾病负担。

Objective To investigate the influencing factors of medical expenses of patients with rheumatoid arthritis and provide policy reference of the implementation of single disease payment standard for relevant departments. Method To conduct a study on 29431 patients with rheumatoid arthritis medical cost data from 2007 to 2011 in health insurance database of Guangzhou and use the nonparametrie test, stepwise regression analysis method to conduct statistical analysis. Result The patient＇s age, gender, type of medical insurance, medical institutions have effect on the medical expenses and the hospital level and the difference has statistical sig- nificance. The drug costs of outpatients accounted for 75.29 % of the total cost, inpatients＇ drug costs accounted for 44.99% of the total cost. In multivariate hnear regression, the variable X5 （hospital level） for the standardized regression coefficient is significantly higher than that of the other variables in the regression coefficient in outpatients or inpatients, respectively 0.168 and 0. 238 , indi- cate that the drug expenses is the main affecting factors of medical expenses of patients. Conclusion To improve the medical insurance payment system and the allocation of health resources and put the drugs of rheumatoid arthritis into medical insurance drug list can al- leviate the burden of the disease patients.