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中国上海精神障碍住院治疗的直接医疗费用:一项时间序列研究。

Direct medical costs of hospitalisations for mental disorders in Shanghai, China: a time series study.

作者信息

Chen Wenming, Wang Shengnan, Wang Qi, Wang Weibing

机构信息

Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.

Department of Epidemiology, Shanghai Key Laboratory of Meteorology and Health, Shanghai, China.

出版信息

BMJ Open. 2017 Oct 30;7(10):e015652. doi: 10.1136/bmjopen-2016-015652.

Abstract

OBJECTIVES

To provide cost burden estimates and long-term trend forecast of mental disorders that need hospitalisations in Shanghai, China.

DESIGN

Daily hospital admissions and medical expenditures for mental disorder hospitalisations between 1 January 2011 and 31 December 2015 were used for analysis. Yearly total health expenditures and expenditures per hospital admission for different populations, as well as per-admission-per-year medical costs of each service for mental disorder hospitalisations, were estimated through data from 2015. We also established time series analyses to determine the long-time trend of total direct medical expenditures for mental disorders and forecasted expenditures until 31 December 2030.

SETTING

Shanghai, China.

PARTICIPANTS

Daily hospital admissions for mental disorders of registered residents living in all 16 districts of Shanghai, who participated in workers' basic medical insurance or the urban residents' basic medical insurance (n=60 306).

RESULTS

From 2011 to 2015, there were increased yearly trends for both hospitalisations (from 10 919 to 14 054) and total costs (from US$23.56 to 42.13 million per year in 2015 currency) in Shanghai. Cost per mental disorder hospitalisation in 2015 averaged US$2998.01. Most direct medical costs were spent on medical supplies. By the end of 2030, the average cost per admission per month for mental disorders was estimated to be US$7394.17 (95% CI US$6782.24 to 8006.10) for mental disorders, and the total health expenditure for mental disorders would reach over US$100.52 million (95% CI US$92.20 to 108.83 million) without additional government interventions.

CONCLUSIONS

These findings suggest total health expenditures for mental disorders in Shanghai will be higher in the future. Effective measures should be taken to reduce the rapid growth of the economic burden of mental disorders.

摘要

目的

提供中国上海需住院治疗的精神障碍的成本负担估计及长期趋势预测。

设计

采用2011年1月1日至2015年12月31日期间精神障碍住院治疗的每日住院人数和医疗支出进行分析。通过2015年的数据估算不同人群的年度总医疗支出、每次住院支出以及精神障碍住院治疗每项服务的每年每次住院医疗费用。我们还建立了时间序列分析,以确定精神障碍直接医疗总支出的长期趋势,并预测到2030年12月31日的支出。

地点

中国上海。

参与者

居住在上海所有16个区、参加了职工基本医疗保险或城镇居民基本医疗保险的登记居民的精神障碍每日住院人数(n = 60306)。

结果

2011年至2015年期间,上海的住院人数(从10919人增至14054人)和总成本(以2015年货币计算,从每年2356万美元增至4213万美元)均呈逐年上升趋势。2015年每次精神障碍住院的成本平均为2998.01美元。大部分直接医疗费用花在了医疗用品上。到2030年底,估计精神障碍每月每次住院的平均费用为7394.17美元(95%可信区间为6782.24美元至8006.10美元),若没有政府的额外干预,精神障碍的总医疗支出将超过1.0052亿美元(95%可信区间为9220万美元至1.0883亿美元)。

结论

这些研究结果表明,上海未来精神障碍的总医疗支出将会更高。应采取有效措施来降低精神障碍经济负担的快速增长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b42/5665299/d8ae26b95465/bmjopen-2016-015652f01.jpg

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