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| 目的：调查菏泽市公立医院5种慢性疾病医疗费用的支付方式。方法：收集菏泽市2012年1月1日至2015年9月31日市立医院、第二人民医院、第三人民医院、市中医医院和传染病医院收治的符合纳入标准的高血压、糖尿病、冠心病、慢支、乙肝5种慢性病患者共计8383例，采集病案首页资料和住院费用明细进行分析。结果：医保患者人均住院总费用、检查费和其他费用显著高于非医保患者（P<0.05），医保患者人均药费显著低于非医保患者（P<0.05）；医保患者中，男性患者住院总支出均显著高于女性（均P<0.05），45岁以上患者医保支出和住院总支出均显著高于45岁以下患者（P<0.05），退休患者医保支出和住院总支出高于在职患者（P<0.05），城镇居民自费支出、医保支出和住院总支出均显著高于农村居民（P<0.05）。结论：慢性病患者的支付方式与其住院费用具有密切关系，同时住院费用也与社会经济学特征有关，值得注意的是，医保在保障居民健康的同时，也极有可能产生过度医疗和资源浪费，需要结合社会情况采取综合措施。 |
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| Investigation on the payment methods of 5 kinds of chronic diseases in public hospitals of Heze |
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| Abstract: |
| Objective Investigated the payment methods of 5 kinds of chronic diseases in public hospitals of Heze. Methods 8383 cases of Hypertension, diabetes, coronary heart disease, chronic bronchitis and hepatitis B were enrolled from The Municipal Hospital, The Second People’s Hospital, The Third People’s Hospital, The City Hospital of Traditional Chinese Medicine and The Infectious Disease Hospital in Heze. The information of medical records and the cost of hospitalization were collected and analyzed. Results The total hospitalization expense, examination fees and other costs of medicare patients were significantly higher than those of the non-medicare patients (P < 0.05), while the drugs expense was significantly lower than that those of non-medicare patients (P < 0.05). As to the medicare patients, hospitalized expense of male patients was significantly higher than that of female (P < 0.05), hospitalized expense and insurance expense of patients over 45 were significantly higher than those of patients under 45 (P < 0.05), hospitalized expense and insurance expense of patients retired were significantly higher than those of patients on-the-job (P < 0.05), total expense of urban patients were significantly higher than those of rural patients (P < 0.05). Conclusion Methods of payment of patients with chronic diseases was in relation with hospitalization expenses, which was also related to the social economic characteristics, but it is worth paying attention to avoiding excessive medical treatment and waste of resources, which need to take comprehensive measures in combination with social situation. |
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