Li Jianjian, Du Hongmei, Dou Feng, Yang Chao, Zhao Yini, Ma Zhibin, Hu Xiaobin
Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, 730000, Lanzhou, Gansu Province, China.
Schizophrenia (Heidelb). 2023 Jan 19;9(1):4. doi: 10.1038/s41537-023-00331-6.
The public health problems caused by schizophrenia are becoming increasingly prominent and can place a huge economic burden on society. This study takes Gansu Province as an example to analyze the level and changing trend of the economic burden of schizophrenia inpatients in economically underdeveloped areas of China. Using a multi-stage stratified cluster sampling method, 39,054 schizophrenics from 197 medical and health institutions in Gansu Province were selected as the research objects, and their medical expenses and related medical records were obtained from the medical information system. The rank sum test and Spearman rank correlation were used for univariate analysis. Quantile regression and random forest were used to analyze the influencing factors. The results show that the average length of stay of schizophrenics in Gansu Province of China was 52.01 days, and the average hospitalization cost was USD1653.96 from 2014 to 2019. During the six years, the average hospitalization costs per time decreased from USD2136.85 to USD1401.33. The average out-of-pocket costs per time decreased from USD1238.78 to USD267.68. And the average daily hospitalization costs increased from USD38.18 to USD41.25. The main factors influencing hospitalization costs are length of stay, proportion of medications, and schizophrenic subtype. The hospitalization costs per time of schizophrenics in Gansu Province have decreased but remain at a high level compared to some other chronic non-communicable diseases. In the future, attention should be paid to improving the efficiency of medical institutions, enhancing community management, and promoting the transformation of the management model of schizophrenia.
精神分裂症所引发的公共卫生问题日益突出，会给社会带来巨大的经济负担。本研究以甘肃省为例，分析中国经济欠发达地区精神分裂症住院患者经济负担的水平及变化趋势。采用多阶段分层整群抽样方法，选取甘肃省197家医疗卫生机构的39054名精神分裂症患者作为研究对象，从医疗信息系统获取其医疗费用及相关病历资料。采用秩和检验和Spearman秩相关进行单因素分析，运用分位数回归和随机森林分析影响因素。结果显示，2014年至2019年中国甘肃省精神分裂症患者平均住院天数为52.01天，平均住院费用为1653.96美元。六年中，每次平均住院费用从2136.85美元降至1401.33美元，每次平均自付费用从1238.78美元降至267.68美元，平均每日住院费用从38.18美元增至41.25美元。影响住院费用的主要因素为住院天数、用药比例和精神分裂症亚型。甘肃省精神分裂症患者每次住院费用虽有所下降，但与其他一些慢性非传染性疾病相比仍处于较高水平。未来，应注重提高医疗机构效率、加强社区管理并推动精神分裂症管理模式转变。
