本文選題：包蟲病 + 住院費用　； 參考：《石河子大學》2013年碩士論文

【摘要】：目的： 調查2007-2011年新疆生產建設兵團包蟲病住院病人的一般信息與費用資料，分析兵團包蟲病住院醫(yī)療費用現(xiàn)狀，探討其主要影響因素，為衛(wèi)生決策者提供參考依據(jù)。 方法： 本研究收集新疆生產建設兵團2007-2011年一家三級醫(yī)院與六家二級醫(yī)院包蟲病患者病例首頁資料及住院醫(yī)療費用信息，用Excel2007建立數(shù)據(jù)庫及校對，利用SPSS17.0軟件對數(shù)據(jù)進行統(tǒng)計描述，采用非參秩和檢驗對影響因素進行單因素分析，采用多元逐步回歸方法對影響因素進行多因素分析，評價各因素對包蟲病住院費用的影響及控制對策。 結果： 1.新疆生產建設兵團2007-2011年七家?guī)熱t(yī)院共收治529例住院病人。年齡從7歲到88歲不等，其中以30~45歲居多；民族以漢族為主，占81%；職業(yè)以農牧民為主；農村患者多于城鎮(zhèn)患者，，依次占59.36%和40.64%；自費患者比例高于醫(yī)�；颊撸髡�82.4%和17.5%；住院天數(shù)集中在10~19天，平均住院日為19天；三級醫(yī)院平均住院日為18天，二級醫(yī)院為20天；治愈與好轉患者手術率為87.8%（389/443）。 2.人均住院費用從2007年的12191.89元上升到2011年的19154.48元；其中漢族16233.90元，排名第一，其次為回族15059.29元；職業(yè)中以干部位居第一18031.87元；城鎮(zhèn)與農村患者相近，依次為15867.80元和15844.25元；自費患者高于醫(yī)�；颊邽�15305.59元和14033.68元；手術患者遠高于非手術患者依次為19239.53元與5713.57元；三級醫(yī)院高于二級醫(yī)院患者為15565.65元與10872.70元。 3.本研究中對包蟲病住院費用的分析重點選擇了住院總費用中的藥品費、治療費、檢查費、手術費、床位費和其它費用作為分析指標。其中藥品費用均數(shù)最高，為5520.2元，其次為檢查費用2420.6元；除治療費用以外，其他費用三級醫(yī)院均高于二級醫(yī)院。 4.經單因素與多因素分析結果顯示，包蟲病住院費用的影響因素是多方面的，住院天數(shù)、出院情況、住院年份、年齡、負擔方式、民族、居住地是住院費用的主要影響因素。 結論： 1.盡管國家加大了對包蟲病手術患者的補助，但隨著近年來住院費用的不斷上漲，新疆生產建設兵團包蟲病患者個人仍需承擔較高的費用。 2.從住院費用支付形式來看，新疆生產建設兵團包蟲病患者參加醫(yī)療保險補助體系的比例仍然很低。 3.從醫(yī)院級別來看，新疆生產建設兵團三級醫(yī)院包蟲病患者住院人數(shù)與住院費用均高于二級醫(yī)院，但三級醫(yī)院的包蟲病患者住院人數(shù)呈現(xiàn)逐年遞減趨勢。 4.藥品費、檢查費在新疆生產建設兵團包蟲病患者住院費用中用占有較大比例，而且仍然存在增長過快現(xiàn)象。
[Abstract]:Objective: To investigate the general information and cost data of hospitalized patients with hydatid disease in Xinjiang production and Construction Corps from 2007 to 2011, to analyze the present situation of hospitalization medical expenses of echinococcosis in Xinjiang production and Construction Corps, to discuss the main influencing factors, and to provide reference basis for health decision makers. Methods: This study collected the data of the first page of cases of hydatid disease in a third class hospital and six level II hospitals of Xinjiang production and Construction Corps from 2007 to 2011, and used Excel2007 to set up a database and proofread the data, and to use SPSS17.0 software to carry on the statistical description to the data. Non-parametric rank sum test was used to analyze the influencing factors and multivariate stepwise regression was used to analyze the influencing factors to evaluate the influence of various factors on the hospitalization expenses of hydatid disease and the control measures. Results: 1. Xinjiang production and Construction Corps in 2007-2011 seven division hospitals a total of 529 hospitalized patients. The ages ranged from 7 to 88 years, of which 300-45 years were the majority; ethnic groups were the Han nationality, accounting for 81%; the occupation was mainly farmers and herdsmen; rural patients were more than urban patients, accounting for 59.36% and 40.64%, respectively; and the proportion of self-funded patients was higher than that of medical insurance patients. The average hospitalization days were 1019 days, 18 days in the third class hospital and 20 days in the second class hospital, and the operative rate of the cured and improved patients was 87.8%. 2. The cost of hospitalization per capita increased from 12191.89 yuan in 2007 to 19154.48 yuan in 2011, including 16233.90 yuan for Han nationality, the first for Han nationality, 15059.29 yuan for Hui nationality, 18031.87 yuan for cadres, 15867.80 yuan for urban patients and 15844.25 yuan for rural patients. The self-funded patients were 15305.59 yuan and 14033.68 yuan higher than the medical insurance patients; the operation patients were 19239.53 yuan and 5713.57 yuan respectively higher than the non-operative patients; the third class hospitals were 15565.65 yuan and 10872.70 yuan higher than the second-class hospitals. 3. In this study, the cost of hospitalization for hydatidosis was analyzed by selecting the total cost of drugs, treatment, examination, operation, bed and other expenses as the analysis index. The average cost of drugs is the highest, which is 5520.2 yuan, followed by 2420.6 yuan of inspection expenses, except for the treatment expenses, the other three level hospitals are all higher than the second class hospitals. 4. The results of univariate and multivariate analysis showed that there were many factors affecting the hospitalization cost of hydatid disease. The days of hospitalization, discharge, year of hospitalization, age, burden mode, nationality and residence were the main factors affecting the cost of hospitalization. Conclusion: 1. Although the state has increased the subsidies for patients undergoing echinococcosis surgery, with the increasing cost of hospitalization in recent years, individuals of echinococcosis patients in Xinjiang production and Construction Corps still have to bear higher costs. 2. The proportion of patients with hydatid disease in Xinjiang production and Construction Corps is still very low. 3. From the hospital level, the number and expense of patients with hydatid disease in the third level hospital of Xinjiang production and Construction Corps were higher than those of the second class hospital, but the number of patients with hydatid disease in the third level hospital showed a decreasing trend year by year. 4. In Xinjiang production and Construction Corps, the cost of medicine and examination accounts for a large proportion of the cost of hospitalization of patients with hydatid disease, and there is still a phenomenon of excessive growth.
【學位授予單位】：石河子大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R825.3

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