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目的比较乌鲁木齐新农合糖尿病患者构成及住院费用变化情况,探讨进一步降低糖尿病患病率,控制糖尿病医疗费用的方法。方法收集整理2012年-2015年间乌鲁木齐市新农合糖尿病患者的医保结算资料,对其性别、族别、年龄、疾病类型、就诊机构、住院天数等进行回顾性分析,比较分析不同特征患者住院人次及费用补偿情况。结果 4年间不同特征糖尿病患者人次均呈持续增长趋势,2015年达到1725人次,患者以41岁~64岁、2型糖尿病、二级医院就诊、住院天数为8天~14天等特征为主;糖尿病患者平均住院费用也呈持续增长趋势,2015年平均住院费用为3319元,医疗费用占比、材料费占比及实际补偿比有所上升,药费占比有所下降;不同特征患者间住院费用均存在差异且差异有统计学意义(P<0.05)。结论对于糖尿病患者应加强糖尿病早期筛查,加大重点人群健康教育;提升基层医疗机构服务质量,实现糖尿病社区管理;推进DRGs付费制度,根据疾病类型、年龄等特征设置合理补偿比例。
Objective To compare the changes of composition and hospitalization costs of new rural patients with diabetes in Urumqi and explore ways to further reduce the prevalence of diabetes and control the medical costs of diabetes. Methods The data of medical insurance of diabetic patients in Urumqi from 2012 to 2015 were collected and analyzed, and their gender, ethnicity, age, types of diseases, visiting institutions and days of hospitalization were analyzed retrospectively. The hospitalization times of patients with different characteristics were compared And the cost of compensation. Results The number of patients with different characteristics of diabetes mellitus showed an increasing trend in 4 years, reaching 1725 in 2015, with 41 to 64 years of age, type 2 diabetes, secondary hospital visits and hospitalization days of 8 days to 14 days. Average hospitalization costs of diabetic patients also continued to increase. In 2015, the average cost of hospitalization was 3,319 yuan. The proportion of medical expenses, the proportion of material expenses and the actual compensation rate increased while the proportion of medical expenses dropped. Hospitalization of patients with different characteristics There are differences in cost and the difference was statistically significant (P <0.05). Conclusion Early screening of diabetes patients should be strengthened and health education of key population should be intensified. The service quality of primary health care institutions should be improved so as to realize community management of diabetes. DRGs payment system should be promoted, and a reasonable compensation rate should be set according to the characteristics of disease type and age.