女性艾滋病病人罹患机会性感染的住院治疗费用分析

目的 分析女性艾滋病病人因罹患机会性感染而住院的治疗费用情况。 方法 收集2008-2010年某疫情严重地区因机会性感染而住院的43例女性病人资料,包括基本情况、机会性感染类型、治疗费用;比较分析不同特征病人的各项治疗费用的差异。 结果 女性艾滋病病人治疗机会性感染的住院总费用平均为(3 418.6±2 671.3)元,检查费、化验费、药品费、诊疗费、护理费、床位费平均分别为(327.0±427.7)元、(354.6±363.6)元、(1 659.5±1 457.0)元、(450.4±485.8)元、(347.0±237.2)元、(280.1±187.1)元。不同民族感染者上述各项费用差异无统计学意义(均P>0.05)。不同职业中检查费和化验费差异有统计学意义(H=11.775、14.010,均P<0.05)。不同文化程度中化验费差异有统计学意义(H=9.007,P<0.05)。不同年龄中检查费和化验费差异有统计学意义(H=8.788、10.997,均P<0.05)。不同感染途径中化验费差异有统计学意义(U=-2.133,P<0.05)。不同类型机会性感染病人的护理费差异有统计学意义(H=9.082,P<0.05)。不同医院级别中三级医院费用均高于二级医院,其中检查费和化验费差异有统计学意义(U=-4.112、-4.697,均P<0.05)。 结论 该疫区女性艾滋病病人罹患机会性感染的住院治疗费用中, 药品费占病人住院总费用的比例最高,导致病人个体费用差别的主要是检查费和化验费;三级医院治疗艾滋病机会性感染的检查费和化验费均高于二级医院,应建立必要的转诊机制,以节约医疗资源;需增大对女性艾滋病病人住院费用的减免力度,以减少因病致贫现象。

Hospitalization expenses of opportunity infection treatment among female patients with AIDS

Objective To analyze the hospitalization expenses of opportunity infection treatment in female AIDS patients. Methods We collected the information about opportunity infection treatment of 43 female patients with AIDS in an HIV epidemic area in 2008-2013, including basic information, the types of opportunistic infections and treatment expenses. The costs of each therapy item were compared among patients with different characteristics. Results The average total hospitalization expenditure for opportunity infection treatment in the 43 female AIDS patients were (3,418.6±2,671.3) Yuan, and the average costs of physical examination, laboratory testing, drugs, diagnosis, nursing and inpatient bed were (3,327.0±427.7) Yuan, (354.6±363.6) Yuan, (1,659.5±1,457.0) Yuan, (450.4±485.8) Yuan, (347.0±237.2) Yuan and (280.1±187.1) Yuan respectively. No statistically significant differences were found in the above-mentioned expenditures among patients from different ethnic groups (all P>0.05). There were statistically significant differences in the expenditures for physical examination and laboratory testing among patients with different occupations (H=11.775, H=14.010, both P<0.05), for laboratory testing among patients with different educational backgrounds (H=9.007, P<0.05), for physical examination and laboratory testing among patients with different ages (H=8.788, H=10.997, both P<0.05), for laboratory testing among patients with different transmission routes (U=-2.133, P<0.05) and for nursing among patients with different types of opportunistic infections (H=9.082, P<0.05). The expenditures were all higher in the third-level hospitals than in the second-level hospitals, with statistically significant differences in the expenditures for physical examination and laboratory testing (U=-4.112, U=-4.697, both P<0.05). Conclusions In the hospitalization expenses of opportunity infection treatment in female AIDS patients in the epidemic area, drug expenses account for the highest proportion. The differences in the individual hospitalization costs are mainly due to the expenditures for physical examination and laboratory testing. The expenditures for physical examination and laboratory testing in the third-level hospitals are both higher than those in the second-level hospitals. Necessary referral mechanism should be established for saving medical resources, and reducing and exempting the hospitalization expenses for female AIDS patients should be intensified to decline the likelihood of poverty due to AIDS.