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按慢性病指标(CCI)划分的老年人慢性病患病率和医疗支出。

The prevalence of chronic conditions and medical expenditures of the elderly by chronic condition indicator (CCI).

机构信息

Department of Health Care Administration, Chang Jung Christian University, No. 396, Sec. 1, Changrong Rd., Tainan County 71101, Taiwan.

出版信息

Arch Gerontol Geriatr. 2011 May-Jun;52(3):284-9. doi: 10.1016/j.archger.2010.04.017. Epub 2010 May 10.

Abstract

The aim of this study was to understand the prevalence of chronic conditions and medical expenditures of the elderly for health care planning development of chronic conditions. This research is based on the representative sample (N=114,873) of seniors over 65 years nationwide. The CCI by the U.S. Agency for Healthcare Research and Quality (AHRQ), and clinical classifications software (CCS) were adopted to determine chronic condition diagnosis codes and classify the diseases. The results are presented by descriptive and multiple regression analysis. The chronic condition prevalence for seniors is 70.4% and the medical expenditures for seniors with chronic conditions accounts for 92.7% of the total medical expenditures for seniors, while 25% of the medical expenditure is spent on 8.2% of seniors who have five chronic conditions and above. Chronic conditions suffered by the elderly, in the order of its prevalence, are hypertension (36.1%), COPD (23.7%), and cataracts (16.7%). From the viewpoint of annual average medical expenditures, cardiovascular diseases rank the most costly diseases, with average medical expenditures as high as $4291. Urinary disease and diabetes ranks the second and the third most costly with an average expenditure of $3644 and $3594. This research showed that the average medical expenditure for seniors with chronic conditions is 5.4 times higher compared with seniors without chronic conditions. It is recommended to further study the characteristics of the target population that spends the most in medical expenditures to outline a more beneficial disease management model, reduce avoidable medical costs and achieve the goal of saving medical resources.

摘要

本研究旨在了解老年人慢性病的患病率和医疗支出情况,为慢性病的医疗保健规划发展提供依据。本研究基于全美 65 岁以上老年人的代表性样本(N=114873)。采用美国医疗保健研究与质量局(AHRQ)的 CCI 和临床分类软件(CCS)来确定慢性病的诊断代码并对疾病进行分类。结果采用描述性和多元回归分析进行呈现。研究结果显示,老年人的慢性病患病率为 70.4%,患有慢性病的老年人的医疗支出占老年人总医疗支出的 92.7%,而 25%的医疗支出用于患有五种及以上慢性病的老年人,占老年人总数的 8.2%。老年人常见的慢性病按患病率排序依次为高血压(36.1%)、COPD(23.7%)和白内障(16.7%)。从年度平均医疗支出的角度来看,心血管疾病的花费最高,平均支出高达 4291 美元;其次是泌尿系统疾病和糖尿病,分别为 3644 美元和 3594 美元。本研究表明,患有慢性病的老年人的平均医疗支出是没有慢性病的老年人的 5.4 倍。建议进一步研究医疗支出最多的目标人群的特征,制定更有利的疾病管理模式,减少不必要的医疗费用,实现节约医疗资源的目标。

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