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目的了解浙江省定点医院结核病患者直接医疗费用及其构成,为优化结核病防治经费配置提供依据。方法采用多阶级抽样方法,选择慈溪等7个县(市、区)为研究地区,在每个地区连续纳入50例初治满疗程的患者进行问卷调查,共调查350例;同时查阅定点医院结核病门诊病案和住院部病历等获取相关医疗费用信息。结果初治肺结核患者医疗费用人均4 086元,占其家庭年总收入的12.69%,20.17%的患者因患结核病发生借贷;患者在结核病定点医院人均医疗费用3 020元,其中78.31%(2 365元)在结核病门诊完成DOT治疗。结核病门诊的费用中,检查费用占25.24%(其中CT费用占8.57%);非免费药品占74.76%(其中保肝药费用占41.94%)。结论肺结核患者医疗费用个人负担较重,建议调整现有的结核病防治经费使用和资源配置。
Objective To understand the direct medical costs and the composition of tuberculosis patients at designated hospitals in Zhejiang Province and provide the basis for optimizing the allocation of funds for tuberculosis prevention and treatment. Methods A multistage sampling method was used in this study. Seven counties (cities and districts) in Cixi were selected as research areas. Fifty patients with initially treated treatment in each area were enrolled in this study. A total of 350 cases were investigated. At the same time, Outpatient medical records and inpatient medical records access to relevant medical expenses information. Results The average cost of medical treatment for newly diagnosed tuberculosis patients was 4 086 yuan, accounting for 12.69% of the total annual family income. 20.17% of the patients borrowed money for tuberculosis. The average per capita medical expenses of the designated tuberculosis hospital was 3 020 yuan, of which 78.31% (2 365 Yuan) DOT treatment completed in TB clinic. Of the costs of tuberculosis clinic, examination fees accounted for 25.24% (of which CT expenses accounted for 8.57%); non-free medicines accounted for 74.76% (of which liver drug costs accounted for 41.94%). Conclusion Patients with tuberculosis have a heavier personal medical expenses, so it is suggested to adjust the existing funds for the prevention and treatment of tuberculosis and to allocate resources.