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2015-2020 年辽宁省门诊焦虑障碍患者的治疗性卫生服务支出——基于《2011 年卫生核算体系》

Curative care expenditure of outpatient anxiety disorder in Liaoning Province, 2015-2020-based on "System of Health Accounts 2011".

机构信息

Department of Traditional Chinese Medicine, School of Graduate Students, Liaoning University of Traditional Chinese Medicine, Shenyang, China.

China National Health Development Research Center, Beijing, China.

出版信息

Front Public Health. 2024 Jul 3;12:1329596. doi: 10.3389/fpubh.2024.1329596. eCollection 2024.

Abstract

INTRODUCTION

Anxiety disorders are the most common mental disorder, experienced by more than a quarter of the population. This study examines total outpatient curative care expenditures (CCE) for anxiety disorders and changes in their composition based on the System of Health Accounts 2011 (SHA 2011).

METHODS

This study used multi-stage stratified random from a total of 9,318,513 outpatient sample data by 920 healthcare organizations, a total of 109,703 cases of anxiety disorders from 53 sample organizations (5.76%) from 2015 to 2020. Univariate analysis, multifactor analysis and structural equation modeling (SEM) were used to explore the influential factors affecting outpatient CCE for anxiety disorders.

RESULTS

Anxiety disorder outpatient CCE from 2015 to 2020 continued to increase from CNY 99.39million in 2015 to CNY 233.84 million in 2020, mainly concentrated in western medicine costs, 15-64 years, general hospital, generalized anxiety disorder and public financing. The results of univariate analysis showed statistically significant differences in all subgroups, and the results of multivariate analysis and SEM showed that the choice to purchase western drugs, purchase prepared Chinese drugs, choice to have a checkup, urban employees' basic medical insurance, and 0-14 years old were associated with high anxiety disorder outpatient CCE.

CONCLUSION

Initiatives to improve the essential drug system, reduce the out-of-pocket (OOP) ratio, and strengthen primary health care to effectively reduce the medical burden on patients.

摘要

引言

焦虑障碍是最常见的精神障碍,超过四分之一的人口患有这种障碍。本研究根据 2011 年卫生核算体系(SHA 2011),考察了焦虑障碍的总门诊治愈性医疗支出(CCE)及其构成的变化。

方法

本研究使用多阶段分层随机抽样方法,从 920 家医疗机构的总共 9318513 名门诊样本数据中,抽取了 2015 年至 2020 年 53 家样本机构(5.76%)的 109703 例焦虑障碍病例。使用单因素分析、多因素分析和结构方程模型(SEM)来探讨影响焦虑障碍门诊 CCE 的因素。

结果

2015 年至 2020 年,焦虑障碍门诊 CCE 持续增加,从 2015 年的 9939 万元增加到 2020 年的 23384 万元,主要集中在西药费用、15-64 岁、综合医院、广泛性焦虑障碍和公共筹资方面。单因素分析结果显示,所有亚组均存在统计学差异,多因素分析和 SEM 结果表明,选择使用西药、购买中成药、进行检查、城镇职工基本医疗保险和 0-14 岁与高焦虑障碍门诊 CCE 有关。

结论

需要采取措施完善基本药物制度,降低自付比例,加强基层医疗服务,从而有效减轻患者的医疗负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f20a/11251961/5e2def2a227a/fpubh-12-1329596-g001.jpg

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