2005—2014年福建省直单位参保人群心脑血管疾病患病情况及治疗费用分析

Analysis of cardio-cerebrovascular disease burden on employees covered by Fujian provincial health care in 2005—2014

目的应用大数据处理方法,调查、分析福建省直单位参保人群心脑血管疾病的患病及医疗费用情况,为制订相关防病、控费政策提供参考。方法依据纳入标准,从福建省医疗保险就医数据库中筛选符合高血压、糖尿病、血脂异常、心肌梗死或卒中诊断的患者,并提取其2005.1.1—2014.12.31期间的所有门诊和住院记录,利用Spark等大数据处理工具对数据进行清洗、剔除后,对获得的数据展开分析。结果 (1)2014年福建省直单位参保人群中,心脑血管疾病总患病率为26.60%;(2)10年内心脑血管疾病的患病率呈逐年增长趋势,其中血脂异常的增速最快(19.37%);(3)心脑血管疾病男女患者的比例约为1.57∶1,且疾病呈现较明显的年轻化趋势;(4)10年里心脑血管疾病总费用为15.57亿元,其中住院费用占55%,心脑血管疾病费用在各年度医保基金总支出中约占40%,心肌梗死、卒中住院患者实际补偿比接近80%;(5)10年内心脑血管疾病门诊费用逐年增长,年均增速约为12.98%;住院费用增速略高于门诊费用。结论心脑血管疾病是医保基金支出的主要领域,患者数量及医疗费用呈现持续增长,需尽快采取有效措施遏制疾病发展、降低疾病费用,防控基金风险。

AIM To analyze the prevalence and medical expenses of major cardio-cerebrovascular diseases （CVDs） based on 2005--2014 Fujian Provincial Claims Database, and to investigate the budget risks that cardio-cerebrovascular diseases may bring by using big data proeessing method. METHODS The study judged whether the patients met the diagnosis of CVDs in accordance with their medications, and then extracted the qualified patients＂ medieal records from January 1, 2005 to December 31, 2014. This big data were processed and analyzed by means of large data processing tools. RESULTS （ 1 ） The total prevalence rate of CVDs in employees covered by Fujian Provincial Health Care was 26.60%. （2） The prevalence rate of CVDs showed a trend of sustained growth over the last 10 years, the average annual growth rate of the prevalence of dyslipidemia in particular reached 19.37%. （3） The proportion of CVDs male and female patients was about 1.57 ： 1, and the disease showed a elear trend of younger in age with the growth of CVDs prevalence being even faster in the population below the age of 60 years. （4） Over the 10 years, the cumulative total CVDs cost was 1.557 billion RMB, in whieh inpatient costs accounted for 55%. In each year＇s medical insuranee fund expenditures, CVDs accounted for more than 40%. In CVDs inpatients costs, insurance payments accounted for nearly 80%. （5） The average annual growth rate of CVDs outpatient costs was about 12.98%, with inpatient costs growing faster than outpatient costs. CONCLUSION The sustained growth of the CVDs consumes most of insurance funds. Thus, implementing more poliey incentives, attaching importance to the intervention of blood pressure, blood lipids and other risk faetors, and preventing the occurrence or recurrenee of serious CVDs events may be the key initiatives to effectively reduce the soeial burden of CVDs.