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基于《2011年卫生账户体系》的甘肃省伤害医疗费用核算研究

[Study on calculating the curative care expenditure of injury in Gansu Province based on "A System of Health Accounts 2011"].

作者信息

Zhao M T, Hu Y S, Qi L, Wang N, Cui Q M, Cui Y, Wang L X, Hu X B

机构信息

Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China.

Finance Department, Health Commission of Gansu Province, Lanzhou 730030, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2019 Sep 6;53(9):900-906. doi: 10.3760/cma.j.issn.0253-9624.2019.09.007.

Abstract

To study the distribution and related factors of curative care expenditure (CCE) of injury in Gansu Province in 2017. Based on the "A System of Health Accounts 2011 (SHA 2011)", the curative care expenditure of injury in Gansu Province was calculated and analyzed. The five-stage stratified cluster sampling method was adopted to extract 149 medical and health institutions, 120 township hospitals (including community health service centers), 150 individual clinics and 600 village clinics (including community health service stations). The top-down allocation method was used to calculate the cost of injury treatment in Gansu Province, and the influencing factors were analyzed by multiple linear regression. In 2017, the CCE of injury in Gansu province was 3.831 billion yuan, and the expense in general hospitals was 2.708 billion yuan. Among them, the cost of lower limb injury and head injury were 1.090 and 0.847 billion yuan. People aged 40 to 69 years old spent 1.901 billion yuan on injury treatment, and the CCE of injury treatment for men and women were 2.422 and 1.409 billion yuan respectively. The results of multiple linear regression showed that hospitalization expenditure was significantly associated with length of stay, operation, hospital grade, age, payment method and gender (0.001). The economic burden of injury in Gansu Province is relatively heavy, so it is necessary to focus on preventions for different groups and costly injury sites.

摘要

研究2017年甘肃省伤害的医疗费用支出(CCE)分布及相关因素。基于“2011年卫生账户体系(SHA 2011)”,对甘肃省伤害的医疗费用支出进行计算与分析。采用五阶段分层整群抽样方法,抽取149家医疗卫生机构、120家乡镇卫生院(含社区卫生服务中心)、150家个体诊所和600家村卫生室(含社区卫生服务站)。运用自上而下分配法计算甘肃省伤害治疗费用,并通过多元线性回归分析影响因素。2017年,甘肃省伤害的CCE为38.31亿元,综合医院费用为27.08亿元。其中,下肢伤害和头部伤害费用分别为10.90亿元和8.47亿元。40至69岁人群伤害治疗费用为19.01亿元,男性和女性伤害治疗的CCE分别为24.22亿元和14.09亿元。多元线性回归结果显示,住院支出与住院天数、手术、医院级别、年龄、支付方式和性别显著相关(P<0.001)。甘肃省伤害的经济负担较重,有必要针对不同群体和高费用伤害部位重点预防。

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