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目的了解影响肺结核患者住院费用的主要因素,为有效减轻肺结核患者经济负担提供参考依据。方法采用分层整群随机抽样方法,调查2015年10月—2016年3月西安市肺结核住院患者125例,利用通径分析方法探讨住院费用的影响因素。结果西安市肺结核患者平均住院日为32.70 d,1次住院费用人均18 187.00元。住院天数、文化程度、职业、经济状况及住院原因对住院费用有直接影响,其对住院费用的总效应分别为0.665、-0.022、0.028、0.005及0.033;年龄、痰检结果、有无并发症、治疗类型、治疗转归及医保类型不但对住院费用有直接影响,也有间接影响,其对住院费用的总效应分别为-0.027、0.242、0.083、0.051、0.037及-0.144;婚姻状况、首诊机构、确诊机构及有无药物不良反应对住院费用无影响。结论西安市肺结核患者住院费用较高,且影响因素复杂多样。应加大国家结核病防治经费投入,加强医院管理及大力宣传国家免费政策,各方面相结合才能从根本上减轻肺结核病患者经济负担。
Objective To understand the main factors influencing the hospitalization costs of patients with pulmonary tuberculosis and provide a reference for effectively reducing the financial burden of patients with tuberculosis. Methods A stratified cluster random sampling method was used to investigate 125 inpatients with pulmonary tuberculosis in Xi’an from October 2015 to March 2016. Pathological analysis was used to explore the influencing factors of hospitalization costs. Results The average length of stay of patients with pulmonary tuberculosis in Xi’an was 32.70 days, and the average cost of hospitalization for one time was 18 187.00 yuan. The total number of hospital stays, educational level, occupation, economic status and hospitalization had a direct impact on hospitalization costs, and the total effect on hospitalization expenses was 0.665, -0.022, 0.028, 0.005 and 0.033, respectively. The results of age, sputum examination and the presence or absence of complications , Type of treatment, treatment outcome and type of medical insurance not only have a direct impact on hospitalization costs, but also have an indirect effect on the total cost of hospitalization were -0.027,0.242,0.083,0.051,0.037 and -0.144; marital status, first diagnosis Institutions, diagnosed institutions and the presence or absence of adverse drug reactions have no effect on hospitalization costs. Conclusion The cost of hospitalization for pulmonary tuberculosis in Xi’an is high, and the influencing factors are complex and diverse. Should increase national funding for TB prevention and treatment, strengthen hospital management and vigorously promote the national free policy, all aspects can fundamentally reduce the economic burden of TB patients.