我国中部农村居民糖尿病和高血压可避免住院现状研究

目的分析我国中部农村地区糖尿病和高血压可避免住院现状,为相关政策制定提供参考。方法利用中国-盖茨基金会农村基本卫生保健项目在中国中部农村地区现场调查定量数据,选择5个县2017年和（或）2018年住院病例。应用Stata/MP 14.0软件分析数据。结果共纳入28 392例住院病例,其中,糖尿病可避免住院病例863例,高血压可避免住院病例1 003例。2017年-2018年,糖尿病和高血压可避免住院总费用、次均费用、次均自付费用及占比呈增加趋势,糖尿病和高血压可避免次均住院时长缩短。结论糖尿病和高血压可避免住院现象普遍存在,患者经济负担加重。建议完善初级卫生保健服务体系,加强慢性病健康教育和管理,提高基层门诊报销比例。

Avoidable Hospitalization for Diabetes and Hypertension in Rural Residents in Central China

ObjectiveTo analyze the current situation of avoidable hospitalization for diabetes and hypertension in rural residents in central China to provide policy suggestions.MethodsThe quantitative data from a field survey conducted by the China-Gates Foundation Rural Basic Health Care Project in rural areas of central China was used to select a random sample of hospitalized cases in 2017 and/or 2018 in five counties. Data were analyzed using STATA/MP 14.0 software.ResultsA total of 28 392 hospitalizations were included, of which 863 cases of diabetes and 1 003 cases of hypertension could have been avoided. From 2017 to 2018, total hospitalization costs, average cost per hospitalization, average out-of-pocket cost per hospitalization, and average out-of-pocket cost per hospitalization for diabetes and hypertension showed an increasing trend. The length of avoidable hospitalization and length of stay per hospitalization were decreased for diabetes and hypertension.Conclusion The avoidable hospitalization was common for diabetes and hypertension which increased the economic burden of patients. It was suggested to improve the primary health care service system, strengthen the health education and management of chronic diseases, and increase the reimbursement rate of community-level outpatient clinics.