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中国城市痴呆住院费用:来自广州市两项城市医疗保险计划理赔数据的估计。

Costs of Hospitalization for Dementia in Urban China: Estimates from Two Urban Health Insurance Scheme Claims Data in Guangzhou City.

机构信息

School of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Guangzhou 510080, China.

Department of Health Policy and Management, College of Public Health, University of Georgia, 100 Foster Road, Wright Hall 205D, Athens, GA 30602, USA.

出版信息

Int J Environ Res Public Health. 2019 Aug 3;16(15):2781. doi: 10.3390/ijerph16152781.

Abstract

Dementia is one of the public health priorities in China. This study aimed to examine the hospitalization costs of patients with dementia and analyzed the factors associated with their inpatient costs. This was a prevalence-based, observational study using claims data derived from two urban insurance schemes during the period from 2008 through 2013 in Guangzhou. The extended estimating equations model was performed to identify the main drivers of total inpatient costs. We identified 5747 dementia patients with an average age of 77.4. The average length of stay (LOS) was 24.2 days. The average hospitalization costs per inpatient was Chinese Yuan (CNY) 9169.0 (CNY 9169.0 = US$1479.8 in 2013). The mean inpatient costs for dementia patients with the Urban Employee-based Basic Medical Insurance (UEBMI) scheme (CNY 9425.0 = US$1521.1) were higher than those for patients with the Urban Resident-based Basic Medical Insurance scheme (CNY 7420.5 = US$1197.6) ( < 0.001). Having UEBMI coverage, dementia subtypes, having hypertension, being admitted in larger hospitals, and longer LOS were significantly associated with hospitalization costs of dementia. The costs of hospitalization for dementia were high and differed by types of insurance schemes. Dementia was associated with substantial hospitalization costs, mainly driven by insurance type and long LOS. These findings provided economic evidence for evaluating the burden of dementia in China.

摘要

痴呆症是中国公共卫生的重点之一。本研究旨在考察痴呆症患者的住院费用,并分析与住院费用相关的因素。这是一项基于患病率的观察性研究,使用了 2008 年至 2013 年期间来自两个城市保险计划的理赔数据。采用扩展的估计方程模型来确定总住院费用的主要驱动因素。我们确定了 5747 名平均年龄为 77.4 岁的痴呆症患者。平均住院时间(LOS)为 24.2 天。每位住院患者的平均住院费用为人民币 9169.0 元(2013 年为 1479.8 美元)。参加城镇职工基本医疗保险(UEBMI)计划的痴呆症患者的平均住院费用(CNY 9425.0 = US$1521.1)高于参加城镇居民基本医疗保险计划的患者(CNY 7420.5 = US$1197.6)(<0.001)。有 UEBMI 覆盖、痴呆症类型、患有高血压、在较大的医院住院以及 LOS 较长与痴呆症的住院费用显著相关。痴呆症的住院费用较高,且因保险计划类型而异。痴呆症与大量的住院费用相关,主要由保险类型和 LOS 长驱动。这些发现为评估中国痴呆症的负担提供了经济证据。

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