本文關(guān)鍵詞： 肺結(jié)核 醫(yī)療費(fèi)用 減免政策　出處：《復(fù)旦學(xué)報(bào)(醫(yī)學(xué)版)》2017年05期 　論文類(lèi)型：期刊論文

【摘要】：目的了解上海市閔行區(qū)肺結(jié)核患者確診及治療過(guò)程中的直接醫(yī)療費(fèi)用及其對(duì)家庭造成的經(jīng)濟(jì)負(fù)擔(dān),為進(jìn)一步完善肺結(jié)核減免政策,控制結(jié)核病醫(yī)療費(fèi)用,減輕患者的經(jīng)濟(jì)負(fù)擔(dān)提供依據(jù)。方法對(duì)本區(qū)347例完成治療的肺結(jié)核患者進(jìn)行發(fā)票的收集以及基本信息的問(wèn)卷調(diào)查。用秩和檢驗(yàn)分析不同類(lèi)型肺結(jié)核患者的直接醫(yī)療費(fèi)用;用多元線(xiàn)性回歸分析直接醫(yī)療費(fèi)用的影響因素;采用多個(gè)率的χ~2檢驗(yàn)分析高額醫(yī)療費(fèi)用與年齡、居民年人均可支配收入的關(guān)系。結(jié)果肺結(jié)核患者的直接醫(yī)療總費(fèi)用為5 657元/人次。多元線(xiàn)性回歸分析顯示,直接醫(yī)療費(fèi)用的影響因素有戶(hù)籍、主要就診機(jī)構(gòu)以及有無(wú)合并癥,其中主要就診機(jī)構(gòu)(β'=-0.217)對(duì)直接醫(yī)療費(fèi)用影響較大。醫(yī)療費(fèi)用扣除醫(yī)保報(bào)銷(xiāo)和結(jié)核病控制項(xiàng)目減免之后仍然有7.5%的患者產(chǎn)生高額醫(yī)療費(fèi)用,并且在低收入人群中分布較多。結(jié)論肺結(jié)核確診及治療過(guò)程的直接醫(yī)療費(fèi)用較高,給患者家庭造成了較嚴(yán)重的經(jīng)濟(jì)負(fù)擔(dān),應(yīng)加強(qiáng)對(duì)老年、有合并癥以及貧困群體的肺結(jié)核患者的醫(yī)保報(bào)銷(xiāo)和減免政策。
[Abstract]:Objective to understand the direct medical expenses and the economic burden on families during the diagnosis and treatment of pulmonary tuberculosis patients in Minhang District of Shanghai, so as to further improve the tuberculosis remission policy and control the tuberculosis medical expenses. Methods 347 patients with pulmonary tuberculosis completed treatment in our district were collected invoices and questionnaire survey of basic information. Rank sum test was used to analyze the patients with different types of pulmonary tuberculosis. Receiving medical expenses; Multiple linear regression analysis was used to analyze the influencing factors of direct medical expenses. The high medical cost and age were analyzed by 蠂 ~ 2 test with multiple rates. Results the total direct medical cost of pulmonary tuberculosis patients was 5 657 yuan / person-time. Multiple linear regression analysis showed that the influencing factors of direct medical expenses were household registration. Major medical institutions and complications. Major institutions (尾 -0.217). After deducting medical insurance reimbursement and TB control project relief, there are still 7.5% patients with high medical costs. Conclusion the direct medical cost of the diagnosis and treatment of pulmonary tuberculosis is higher, which has caused a serious economic burden to the patients' families, and should be strengthened to the elderly. Medical reimbursement and remission policies for tuberculosis patients with complications and poverty groups.
【作者單位】： 上海市閔行區(qū)疾病預(yù)防控制中心;復(fù)旦大學(xué)公共衛(wèi)生學(xué)院流行病學(xué)教研室;
【基金】：上海市研究生教育創(chuàng)新計(jì)劃 上海市公共衛(wèi)生與預(yù)防醫(yī)學(xué)Ⅰ類(lèi)高峰學(xué)科建設(shè)計(jì)劃~~
【分類(lèi)號(hào)】：R521
【正文快照】： 中國(guó)是世界上22個(gè)結(jié)核病高負(fù)擔(dān)國(guó)家之一,僅次于印度和印度尼西亞,位居全球第3位[1]。肺結(jié)核多發(fā)生在貧困人群,是導(dǎo)致我國(guó)貧困人群“因貧致病”和“因病返貧”的主要原因之一[2]。第5次結(jié)核病全國(guó)流行病學(xué)抽樣調(diào)查顯示,70%以上肺結(jié)核患者集中在中西部和農(nóng)村地區(qū),80%以上患者的

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