论文部分内容阅读
目的:探讨门诊报销政策对高血压合并并发症患者住院服务利用及费用的影响,为门诊保障政策设计提供实证依据。方法:利用新疆某地区2011—2014年城镇职工医疗保险报销数据,采用有对照的间断时间序列研究,分析享受门诊慢病政策与未享受门诊慢病政策的高血压并发症患者在研究期间因单纯性高血压、高血压并发心脏病、高血压并发肾病及高血压并发脑病入院的每季度总住院费用及总住院时长的水平及趋势变化。结果:2011—2014年,享受政策与未享受政策组患者住院总费用分别降低了33.80%和13.23%,其中享受政策组患者因单纯性高血压而入院的住院费用的降幅高于未享受政策组47.48%,每季度住院总费用呈显著的下降趋势;享受政策组患者因单纯性高血压和高血压并发脑病而住院的患者总住院时长缩短了42.06%和35.02%,而未享受政策组因单纯性高血压住院患者住院时长显著升高。结论:门诊特殊慢病政策降低了高血压合并并发症患者以因单纯高血压为主的住院服务利用及费用,卫生决策者应充分考虑保障不同疾病状态下患者的门诊医疗费用。
Objective: To explore the impact of outpatient reimbursement policy on the utilization of hospital services and the cost of patients with hypertension complicated complications, and provide empirical evidence for the design of outpatient safeguard policies. Methods: The data of reimbursement of medical insurance for urban employees in a certain area in Xinjiang from 2011 to 2014 were used to study the relationship between the chronic obesity-outpatient policy and the uncomplicated outpatient chronic diseases in the study period. Hypertension, hypertension complicated by heart disease, hypertension with nephropathy and hypertensive encephalopathy hospital admission quarterly total hospitalization costs and total length of hospital stay changes in the level and trend. Results: From 2011 to 2014, the total cost of hospitalization of patients who enjoyed policy and those who did not enjoy policy decreased by 33.80% and 13.23% respectively. Among them, the hospitalization expenses of patients in policy group who were admitted to hospital for simple hypertension dropped more than those who did not enjoy policy group 47.48%. The total cost of hospitalization in each quarter showed a significant downward trend. Patients in policy group who were hospitalized due to hypertension and hypertension complicated with encephalopathy had a shorter total length of hospital stay of 42.06% and 35.02% Hypertension hospitalized patients were significantly longer duration of hospitalization. CONCLUSIONS: Outpatient special chronic disease policy reduces the use and cost of hospital-based hypertension-based inpatients with hypertension complications. Health policy makers should give full consideration to ensuring outpatient medical care for patients with different disease states.