老年慢性病人家庭病床与住院治疗的费用差异及主要影响因素

The Costs of In-home Medical Care for Old Patients Suffering From Chronic Diseases and Its influencing Factors Compared with their Hospitalized Counterparts in Many Respects

目的 研究老年慢性病患者家庭医疗护理的费用支付情况及其主要影响因素 ,为广泛开展社区卫生服务提供参考。方法 以老年慢性疾病患者为对象 ,实施家庭医疗与护理。以同类病人的住院结果为对照 ,比较分析了两组病人各项费用支出的平均水平和可能的影响因素。结果 社区家庭医疗护理病人的平均医疗费用为 3 12 8元 ,95 %参考范围是 2 5～ 3 4 3 3 5元 ,日平均费用为 5 2元 ,均低于同类病人住院费用的平均水平。在各种收费项目中 ,药品费在总费用中占了 86 95 %。对社区医疗费用影响较大的是病人的病情和收入情况。结论 社区家庭医疗护理不但可以达到同类病人住院治疗的相同效果 ,且经济、方便 。

Objective To study how the in-home medical care affects the health of older patients with chronic diseases and determine the cost of in-home care,and its affected factors,provide the reference for the current medical system reform of China.Methods The In-home care was put in practice for old patients with chronic diseases.The cost level and its affected factors among the old patients treated in home were analyzed compared with their hospitalized counterparts.Results The average total cost of in-home care is 312 8 Yuan,95% of the scores varying from 24 4～3433 2 Yuan,the average daily cost is 5 2 Yuan,and are all lower than that of inpatients.The cost of druggery is about 87 percent among the whole cost.The disease severity score,the income are main factors impacting the whole cost of patients.Conclusion The in-home medical care for older patients with chronic conditions is worthy to put in practice in communities.It is a important way to solve the problems of older patients whom should be hospitalized.