基于"卫生费用核算体系2011"的甘肃省伤害治疗费用测算研究

Study on calculating the curative care expenditure of injury in Gansu Province based on "A System of Health Accounts 2011"

目的研究甘肃省2017年伤害治疗费用的分布及其相关因素.方法基于"卫生费用核算体系2011",对甘肃省伤害治疗费用进行核算与分析,采用五级分层整群抽样方法,抽取出149家医疗卫生机构、120个乡镇卫生院(含社区卫生服务中心)、150家私人诊所和600所村卫生室(含社区卫生服务站),采用自上而下的分摊方法,核算出甘肃省的伤害治疗费用,并采用多元线性回归分析影响因素.结果 2017年,甘肃省伤害治疗费用为38.31亿元,发生在综合医院的治疗费用高达27.08亿元;下肢损伤和头部损伤的费用分别为10.90亿元和8.47亿元,40~69岁人群的伤害治疗费用为19.01亿元,男女伤害治疗费用分别为24.22亿元和14.09亿元;多元线性回归结果显示,住院天数、是否手术、医院等级、年龄,付费方式和性别对住院费用均有影响(P<0.001).结论甘肃省伤害的疾病经济负担较重,要针对不同人群和治疗费用较高的伤害部位进行重点预防.

Objective To study the distribution and related factors of curative care expenditure (CCE) of injury in Gansu Province in 2017. Methods Based on the "A System of Health Accounts 2011 (SHA 2011)", the curative care expenditure of injury in Gansu Province was calculated and analyzed. The five-stage stratified cluster sampling method was adopted to extract 149 medical and health institutions, 120 township hospitals (including community health service centers), 150 individual clinics and 600 village clinics (including community health service stations). The top-down allocation method was used to calculate the cost of injury treatment in Gansu Province, and the influencing factors were analyzed by multiple linear regression. Results In 2017, the CCE of injury in Gansu province was 3.831 billion yuan, and the expense in general hospitals was 2.708 billion yuan. Among them, the cost of lower limb injury and head injury were 1.090 and 0.847 billion yuan. People aged 40 to 69 years old spent 1.901 billion yuan on injury treatment, and the CCE of injury treatment for men and women were 2.422 and 1.409 billion yuan respectively. The results of multiple linear regression showed that hospitalization expenditure was significantly associated with length of stay, operation, hospital grade, age, payment method and gender (P<0.001). Conclusion The economic burden of injury in Gansu Province is relatively heavy, so it is necessary to focus on preventions for different groups and costly injury sites.