2010-2014 年湖南省巨脾型晚期血吸虫病手术患者直接医疗费用调查分析

目的 目的 了解湖南省巨脾型晚期血吸虫病 （晚血） 手术患者医疗费用及其影响因素。方法 方法 收集2010年1月-2014 年8月湖南省血吸虫病防治所附属湘岳医院收治的巨脾型晚血手术患者费用及病例资料， 对患者各项住院费用及住院天数等进行统计分析， 并对影响患者住院费用的因素进行单因素和多因素分析。结果 结果 2010-2014 年共收治249例晚血手术患者， 平均住院天数28.92 d， 人均住院费用18 896.13元， 均呈逐年增长趋势。在各项费用中， 药品费所占比例均最高， 各年均超过44%。影响医疗费用的因素包括住院天数、 术中出血量、 肝功能分级、 术后并发症、 年龄、 门脉性胃病。结论 结论 湖南省巨脾型晚血患者直接医疗费用负担仍较重。政府应进一步提高医疗救助补偿比例， 完善医疗救助补偿方案； 同时医院应加强管理， 规范诊疗行为， 以减轻患者经济负担。

Investigation of direct medical expense for surgical patients with splenomegalic advanced schistosomiasis in Hunan Province from 2010 to 2014

Objective Objective To understand the direct medical expense for surgical patients with splenomegalic advanced schisto?somiasis and its influencing factors，so as to provide evidences for relevant departments to improve the rescue strategy of ad?vanced schistosomiasis. Methods Methods The data about the expenses of patients with splenomegalic advanced schistosomiasis hospi?talized in Xiangyue Hospital affiliated to Hunan Institute of Schistosomiasis Control from January 2010 to August 2014 were col?lected，the hospitalization expense and hospital stays of the patients were analyzed，and the factors influencing the hospital ex?penses were analyzed by the univariate and multi?factor analyses. Results Results From January 2010 to August 2014，totally 249 cas?es were hospitalized in the hospital，their average hospital stays and hospital expenses were 28.92 d and 18 896.13 Yuan，andboth of them were increased year by year. Among all the kinds of expenses，the constitution ratios of the medicine expenses werethe highest，and those in the 5 years were all above 44%. The results of the univariate and multi?factor analyses showed that thehospital stays，the amount of intraoperative bleeding，liver function classification，postoperative complications，age，portal hy?pertensive gastropathy were the influencing factors of the hospital expenses. Conclusion Conclusion Presently，the burden of the directhospital expenses of the patients with splenomegalic advanced schistosomiasis is still heavy. The government should further im?prove the proportion of the compensation of medical assistance and perfect the medical aid scheme. Meanwhile，the hospitalsshould strengthen the management and standardize medical behavior to reduce the hospitalization expenses of the patients.