原发性骨质疏松患者医疗费用及医疗资源使用研究

Medical expenses and use of medical resources of patients with primary osteoporosis

目的探讨我国原发性骨质疏松患者的医疗费用,比较金天格胶囊与仙灵骨葆胶囊分别联用双膦酸盐治疗的费用差异。方法对中国医疗保险研究会(CHIRA)数据库中2015年上半年被诊断为原发性骨质疏松患者的直接医疗费用、医疗资源利用和骨质疏松治疗用药进行描述性分析;抽取金天格胶囊联合双膦酸盐治疗及仙灵骨葆胶囊联合双膦酸盐治疗的骨质疏松患者临床资料,将其分别设为金天格组(n=98)及仙灵骨葆组(n=125),进行基线匹配,比较两组患者直接医疗成本及医疗资源利用差异。结果骨质疏松患者次均门诊费用为(493.32±522.48)元,次均住院费用为(18 254.31±27 073.41)元;西药使用比例为68%,中成药使用比例为26%;金天格组患者总体费用、住院天数、人均住院频次、人均骨折频次均明显低于仙灵骨葆组患者,差异均具有统计学意义(P<0.05)。结论骨质疏松患者的经济负担较重,对于骨质疏松患者应提高治疗依从性,减少骨折住院事件发生,从而达到节省医疗成本和医疗资源的目的。

Objective To investigate the medical expenses of patients with primary osteoporosis in China,and compare the cost difference between Jintiange Capsule and Xianling Gubao Capsule respectively combined with bisphosphonate.Methods Descriptive analysis was performed on direct medical expenses,use of medical resources and drugs used for osteoporosis of patients with primary osteoporosis in the first half of 2015 in the database of China Medical Insurance Research Association(CHIRA).The clinical data of patients with osteoporosis treated with Jintiange Capsule combined with bisphosphonate and Xianling Gubao Capsule combined with bisphosphonate were collected.They were included into the Jintiange group(n=98)and Xianling Gubao group(n=125),respectively.Baseline matching was performed and the direct medical expenses and use of medical resources were compared between the two groups.Results The average outpatient expenses and hospitalization costs of patients with osteoporosis was(493.32±522.48)yuan and(18 254.31±27 073.41)yuan,respectively.The proportions of using western medicine and Chinese patent medicine were 68%and 26%,respectively.The hospitalization days,frequency of per capita hospitalization and frequency of per capita fractures in the Jintiange group were significantly shorter/lower than those in the Xianling Gubao group(P<0.05).Conclusion The economic burden of patients with osteoporosis is relatively heavier.For patients with osteoporosis,treatment compliance should be improved to decrease the incidence of hospitalization events due to fractures,so as to save medical expenses and medical resources.