上海市123例晚期血吸虫病患者就诊费用及医疗补助特征分析

Analysis on the characteristics of medical expenses and medical subsidies for 123 patients with advanced schistosomiasis in Shanghai

目的研究上海市晚期血吸虫病患者基本情况、医疗费用支出及影响因素情况。方法收集123例上海市浦东新区晚期血吸虫病医疗补助患者的缴费凭证、随防资料,描述患者的基本情况、医疗费用支出情况。对门诊、住院费用的多因素分析采用Logistic回归分析,以P<0.05为差异有统计学意义。结果患者平均年龄为(69.97±8.26)岁。患者门诊费用前5位为西药费、中成药费、中草药费、化验费及检查费,住院费用前5位为西药费、化验费、材料费、中成药费及诊/治疗费。门诊费用中,年龄、文化程度(初中、大专及以上)、就诊季度(第2季度)3种因素与医疗费用呈正相关关系(b>0,OR>1)。住院费用中,仅年龄与医疗费用呈正相关关系(b>0,OR>1)。2016—2020年人均补助费用分别为2417.88元、2302.22元、1886.19元、1890.33元及2371.58元,分别占人均自付医疗费用的32.66%、31.90%、46.06%、29.02%和23.69%,占人均医疗总费用的13.04%、9.00%、10.73%、8.15%和5.02%。结论浦东新区晚期血吸虫病患者医疗费用补助标准需要进一步提高。

Objective To study the basic situation,medical expenses and influencing factors of patients with advanced schistosomiasis in Shanghai.Methods Payment vouchers and follow-up data of 123 Medicaid patients with advanced schistosomiasis in Pudong New Area of Shanghai were collected,and the basic situation of the patients and medical expenses were described.Logistic regression analysis was used for multivariate analysis of outpatient and inpatient expenses,and the differerce was considered statistically significant when P<0.05.Results The average age of the patients was(69.97±8.26).The top five outpatient expenses for patients were western medicine,proprietary Chinese medicine,Chinese herbal medicine,laboratory test and examination fees.The top five hospitalization expenses were western medicine fee,laboratory fee,material fee,Chinese patent medicine fee,diagnosis and treatment fee.Outpatient expenses showed that age,educational level(junior high school,junior college and above),and visiting quarter(the second quarter)those three factors were positively correlated with medical expenses(b>0,OR>1).Hospitalization expenses showed that only age was positively correlated with medical expenses(b>0,OR>1).From 2016 to 2020,the average subsidy cost per capita were 2417.88,2302.22,1886.19,1890.33and 2371.58 yuan respectively.The subsidy expenses per capita accounted for 32.66%,31.90%,46.06%,29.02%,and 23.69%of the out-of-pocket health care cost per capita respectively,and the proportions of the total health care medical expenses per capita were 13.04%,9.00%,10.73%,8.15%and 5.02%,respectively.Conclusions The subsidy standard of medical expenses for patients with advanced schistosomiasis in Pudong New Area needs to be further raised.