甘肃省会宁县2015年住院患者疾病构成及费用分析

Analysis on the Disease Constitution and Cost of Inpatients in Huining County of Gansu in 2015

目的分析2015年甘肃省会宁县新农合分级诊疗住院患者疾病构成及费用情况,为优化分级诊疗政策提供决策依据。方法按照国际疾病标准(ICD-10)对住院患者前5位疾病构成按不同性别、年龄组和医疗机构进行顺位对比分析,并对住院费用分不同补偿类型与医疗机构进行对比分析。结果会宁县全年住院患者共计12 254例,男女之比为0.63∶1;慢性阻塞性肺疾病、高血压、正常分娩、冠心病和小儿支气管肺炎为该县主要病种;住院费用的总体可补助医药费比例为95.6%,总体实际补偿比为55.5%;分级诊疗患者占新农合住院患者的51.4%;县内住院率为82.4%。结论 2015年会宁县住院患者女性住院例数多于男性,以慢性疾病为主,且慢性阻塞性肺疾病居于首位;住院费用的实际补偿比例较低;分级诊疗、县内医疗机构的住院患者住院费用相对较低。

OBEJECTIVE To analyze disease constitution and cost analysis of inpatients in Huining county in 2015, so as to provide the decision basis of improving hierarchical diagnosis and treatment. METHODS According to the international classification of dis- ease standard（ICD-10） to analyze the top five disease constitution of sex, age and medical institution and the cost analysis of compen- sation type and medical institution. RESULTS A total of 12 254 cases of inpatients in Huining County in 2015 and the inpatients compared to male and female were 0.63：1. The major disease of Huining County were chronic obstructive pulmonary disease, hyperten- sion, normal delivery, coronary heart disease and pediatric bronchial pneumonia. The proportion of subsidized medical expenses and actual compensation were 95.6% and 55.5%, respectively. The Inpatients of hierarchical diagnosis and treatment and hospitalized in the county accounted for 51.4% and 82.4%, respectively. CONCLUSION The inpatients of Huining county in 2015 had more female than male and the main desease were chronic disease and chronic obstructive pulmonary disease up to the first. The proportion of ac- tual compensation of inpatient＇ s costs was relatively low. The inpatients of hierarchical diagnosis and hospitalized in the county, which were relatively low.