艾滋病治疗费用影响因素的多元线性回归分析

Multiple regression analysis of factors influencing the costs of treatment for AIDS

目的分析影响艾滋病患者治疗费用的主要因素，为制定医疗政策和节约医疗成本提供科学依据。方法对2010年6月～2011年12月兰州市某医院初次进行国家免费艾滋病抗病毒治疗的110例艾滋病患者进行治疗费用调查。采用EpiData3．1软件进行数据的双录入、核对整理，用SPSS17．0软件统计，用χ^2检验分析并发症和基线CD4水平的关系，用单因素秩和检验及多元线性回归分析影响治疗费用的因素。结果110例病例中治疗费用记录完整的资料100例，χ^2检验显示，基线CD4水平和出现并发症以及并发症数目有关（P〈0．01）；治疗费用的单因素分析显示，治疗费用与基线CD4水平和并发症数目有关（P〈0．05，P〈0．01），与性别、年龄、民族、文化程度和基线病毒载量无关（P〉0．05）；用逐步回归分析法建立多元线性回归方程：Y（治疗费用）=2003．779＋2870．311X（并发症数目），方差分析显示F=33．170（P〈0．01），治疗费用与并发症数目有线性关系；R^2=0．349，R=0．590，说明并发症数目占治疗费用的34．9％，并发症数目与治疗费用密切相关，差异有统计学意义（t=5．759，P〈0．01）。结论基线CD4水平越低越容易出现并发症，而且易出现多个并发症，并发症数目是导致艾滋病患者高昂治疗费用的最主要因素，通过预防和控制并发症，可以大幅降低患者治疗费用。

Objective To analyze the major factors influencing the costs of treatment for AIDS. Methods A total of 110 cases in a hospital for their initial antiviral therapy were recruited from June 2010 to December 2011 in Lanzhou city of China. Chi-square test was used to determine the association between clinical complica- tions and the baseline CD4 counts. Single factor and multiple regression analysis were done to analyze the influ- encing factors of the costs of treatment. Results Of all 110 cases, 100 had complete data for further analy- sis. Chi-square test showed that CD4 baseline was closely related to the clinical complications and the number of clinical complications （P〈0.01） . Univariate analysis also showed that CD4 baseline and the number of com- plications could significantly affect the costs of treatment for AIDS （P〈0.05） while gender, age, nationali- ty, level of education, and viral load baseline could not （P〈0.05） . Multiple regression analysis showed that linear regression equation： Y （cost of treatment） = 2 003. 779 ＋ 2 870. 311X （number of clinical complica- tions）, F=33. 170 （P〈0.01）, R2 =0. 349, R=0. 590. The number of clinical complications could signifi- cantly affect the costs of treatment for AIDS （P〈0. 001） . Conclusions Low CD4 baseline easily leads to the occurrence of clinical complications for AIDS patients. The number of complications is the most important factor contributing to the high costs of treatment for AIDS. The costs of treatment for AIDS could be greatly reduced by preventing and control of clinical complications.