社区高血压患者健康管理药物治疗和直接医疗费用分析
사구고혈압환자건강관리약물치료화직접의료비용분석
The analysis of drug cost and direct medical expense in community health management of hypertensive patients
  • 万方数据
    中华预防医学杂志 중화예방의학잡지
    CHINESE JOURNAL OF
    2011年 8期 732-736 ,共5页

    梁小华%顾东风%张欢%朱坤%邓颖%曹杰%周正元%王仪%万国生%赵川%牟全成%路方红

    량소화%고동풍%장환%주곤%산영%조걸%주정원%왕의%만국생%조천%모전성%로방홍

    高血压%医院%社区%公共卫生管理%成本效益分析 高血壓%醫院%社區%公共衛生管理%成本效益分析
    고혈압%의원%사구%공공위생관리%성본효익분석
    Hypertension%Hospitals,community%Public health administration%Cost-benefit analysis
    目的 调查社区高血压患者健康管理的药物治疗费用、住院费用及直接医疗费用的现状,为进一步评估国家基本公共卫生服务项目中的社区高血压患者健康管理是否具有卫生经济学上的成本效益奠定基础.方法 通过整群抽样的方法在5省10个调查点调查了8326例高血压患者,其中参与社区高血压患者健康管理1年以上的管理组对象3967例,未参与该管理的对照组4359例.通过问卷调查收集研究对象基本信息,并回顾性收集其在过去1年内(2009年11月至2010年11月)的医疗成本信息.分别对比分析两组患者的年度药物治疗费用、住院治疗费用和直接医疗费用.结果 高血压患者年均药物治疗费用为(621.50±1337.78)元,管理组为(616.13±1248.40)元,对照组为(626.44±1414.30)元.高血压服药患者年均药物治疗费用为(702.05±1401.79)元,管理组为(688.50±1300.70)元,对照组为(714.64±1489.60)元.城市高血压服药患者年均药物治疗费用[(731.88±1403.31)元]高于农村[(407.44±1171.44)元].高血压患者的年住院率为12.2%(1014/8326),高血压住院患者年人均住院费用为(9264.47±18 088.49)元,管理组[(7583.70±13 267.00)元]低于对照组[(11 028.00±21 919.00)元].高血压患者年人均住院费用为(1064.87±6804.83)元,管理组[(936.73±5284.90)元]低于对照组[(1181.50±7937.90)元].高血压患者年人均直接医疗费用为(2275.08±8225.66)元,管理组为(2165.10±6564.60)元,对照组为(2375.20±9487.60)元;城市地区患者年人均直接医疗费用[(2801.06±9428.54)元]高于农村[(1254.70±4990.27)元].结论 高血压社区健康或规范化管理能降低高血压服药患者年均药物治疗费用和患者年人均住院费用约26元和245元;节省高血压患者年人均直接医疗费用约210元.国家医疗卫生体制改革和发展中,应进一步加强和推广社区高血压患者健康或规范化管理.
    목적 조사사구고혈압환자건강관리적약물치료비용、주원비용급직접의료비용적현상,위진일보평고국가기본공공위생복무항목중적사구고혈압환자건강관리시부구유위생경제학상적성본효익전정기출.방법 통과정군추양적방법재5성10개조사점조사료8326례고혈압환자,기중삼여사구고혈압환자건강관리1년이상적관리조대상3967례,미삼여해관리적대조조4359례.통과문권조사수집연구대상기본신식,병회고성수집기재과거1년내(2009년11월지2010년11월)적의료성본신식.분별대비분석량조환자적년도약물치료비용、주원치료비용화직접의료비용.결과 고혈압환자년균약물치료비용위(621.50±1337.78)원,관리조위(616.13±1248.40)원,대조조위(626.44±1414.30)원.고혈압복약환자년균약물치료비용위(702.05±1401.79)원,관리조위(688.50±1300.70)원,대조조위(714.64±1489.60)원.성시고혈압복약환자년균약물치료비용[(731.88±1403.31)원]고우농촌[(407.44±1171.44)원].고혈압환자적년주원솔위12.2%(1014/8326),고혈압주원환자년인균주원비용위(9264.47±18 088.49)원,관리조[(7583.70±13 267.00)원]저우대조조[(11 028.00±21 919.00)원].고혈압환자년인균주원비용위(1064.87±6804.83)원,관리조[(936.73±5284.90)원]저우대조조[(1181.50±7937.90)원].고혈압환자년인균직접의료비용위(2275.08±8225.66)원,관리조위(2165.10±6564.60)원,대조조위(2375.20±9487.60)원;성시지구환자년인균직접의료비용[(2801.06±9428.54)원]고우농촌[(1254.70±4990.27)원].결론 고혈압사구건강혹규범화관리능강저고혈압복약환자년균약물치료비용화환자년인균주원비용약26원화245원;절성고혈압환자년인균직접의료비용약210원.국가의료위생체제개혁화발전중,응진일보가강화추엄사구고혈압환자건강혹규범화관리.
    Objective To investigate the current situation of drug cost,hospitalization cost and direct medical expense in community health management of hypertensive patients,in order to lay foundation for evaluating whether the community health management in basic public health service has cost-effect in Health Economics.Methods A total of 8326 hypertensive patients from 10 survey pilots in 5 provinces were selected by cluster sampling methods,including 3967 patients who took part in community health management for over 1 year as management group and 4359 cases who have never taken part in community health management as control group.The essential information of research objects were collected by questionnaire; and the medical cost information in the last year(from November 2009 to November 2010) were collected retrospectively.The different annual medical treatment cost,hospitalization cost and direct medical expense in the two groups were compared and analyzed.Results The average annual drug cost in hypertension was(621.50±1337.78) yuan per patient; while the cost was(616.13±1248.40) yuan in management group and(626.44±1414.30) yuan in control group respectively.The average annual drug cost of hypertensive patients who took medicine therapy was(702.05±1401.79) yuan per person,while the cost in the management group ((688.50±1300.70)yuan) was much lower than it in control group ((714.64±1489.60)yuan).The annual average drug cost in urban was(731.88±1403.31) yuan per person,which was higher than it in rural as(407.44±1171.44) yuan per person.The average hospitalized rate was 12.2%(1014/8326),and the average annual cost among the hospitalized patients was(9264.47±18 088.49) yuan per person; while the cost was(7583.70±13 267.00) yuan in management group,which was lower than it in control group as(11 028.00±21 919.00) yuan.The average annual hospitalized cost in hypertensin was(1064.87±6804.83) yuan per person; while the cost was(936.73±5284.90) yuan in management group,which was lower than it in control group as(1181.50±7937.90) yuan.The average annual direct medical expense in hypertension was(2275.08±8225.66)yuan per person; while the expense was(2165.10±6564.60)yuan in management group and(2375.20±9487.60)yuan in control group.The average annual direct medical expense in urban((2801.06±9428.54)yuan per person) was higher than it in rural((1254.70±4990.27)yuan per person).Conclusion The community health or standardized managment of hypertensive patients can reduce the average annual drug cost and hospitalization cost (around 26 yuan and 245 yuan separately); and thereby save the annual direct medical expense per capita in hypertension (around 210 yuan). In the reform and development of national medical health system, we should enhance and promote the standardized community health management of hypertensive patients.
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