强直性脊柱炎医保患者费用分析

Analysis on the Direct Medical Cost of Patients with Ankylosing Spondylitis

利用中国医疗保险研究会2013年抽样医保数据库对强直性脊柱炎城镇患者直接医疗费用进行回顾性研究了解强直性脊柱炎的主要药物治疗方案,比较不同药物治疗方案对医疗费用的影响。通过强直性脊柱炎诊断编码,检索医保数据,共获得1299名患者药物治疗信息。其中,234人接受非甾体抗炎药(NSAID)治疗,146人接受疾病修饰抗风湿药(DMARD)治疗,626名患者接受NSAID联合DMARD治疗,60名患者接受生物制剂治疗,233名患者接受无特异性药物治疗。这些治疗方案直接医疗费用的中位值范围在2702元(无特异性药物组)至14539元(生物制剂组)之间。接受生物制剂治疗的患者校正后并发症风险最低(比数比0.200,p=0.017)。生物制剂治疗对并发症风险的降低作用可能部分抵消其高价格对医疗费用的影响。

By retrospectively analyzing the sampling insurance data of patients with Ankylosing Spondylitis （AS） collected by China Health Insurance Research Association （CHIRA） 2013, to estimate the direct medical costs associated with AS, to understand the treatment prescriptions, and to compare the impact on the cost. 1299 cases were selected by searching insurance database. For them, the treatment prescriptions included nonsteroidal anti-inflammatory drugs （NSAID） （n=234）, disease-modifying anti-rheumatic drugs （DMARD） （n=146）, combination of NSAID and DMARD （n=626）, biologics （n=60）, and non-specific drugs （n=233）. The median total medical costs ranged from 2702 （RMB） for non-specific drug treatment to 14,539 （RMB） for biologics treatment. Biologics treatment was significantly associated with the lowest risk of AS-related complications （odds ratio=0.200, p=0.017）. The reduced risk of AS-related complications associated with biologics treatment might offset the high treatment costs.