He Yuxin, Tan Juntao, Tan Qingzhu, Zhang Xiao, Liu Yunyu, Tang Yang
Department of Medical Administration, Affiliated Banan Hospital of Chongqing Medical University, Chongqing, China.
College of Medical Informatics, Chongqing Medical University, Chongqing, China.
Front Public Health. 2025 Mar 10;13:1559424. doi: 10.3389/fpubh.2025.1559424. eCollection 2025.
Type 2 diabetes mellitus (T2DM) is a chronic non-infectious disease that seriously endangers human health. This study aimed to determine the main factors influencing the medical expenditure of T2DM patients and provide guidance for the allocation and control of medical expenditure.
The homepage data of patients with T2DM were retrospectively collected from six tertiary hospitals in southwest China from January 2011 to December 2021. A multiple linear regression model was constructed to examine the factors associated with medical expenses per patient. Furthermore, the trends of medical expenditure according to other important measures and patient subgroups were described, and a proportional breakdown of medical expenditure was generated. All expenditure data were reported in Chinese Yuan (CNY), based on the 2021 value, and adjusted using the year-specific healthcare consumer price index.
A total of 45,237 patients with T2DM were analyzed in this study. Multiple linear regression showed that age, marital status, insurance type, length of stay, number of clinical visits, number of comorbidities, history of disease, history of surgery, smoking history, and the age-adjusted Charlson comorbidity index score were influencing factors of medical expenditure in patients with T2DM. Considering the overall average medical expenditure, diagnosis cost accounted for the largest proportion and was never <25% since 2011, showing a decreasing trend year by year. Among the types of comorbidity, hypertension was the most prevalent, followed by kidney disease and hyperlipidemia. In terms of the combination of comorbidities, medical expenditure was the highest for pulmonary infection+hypertension (24,360 CNY), followed by coronary heart disease+heart failure+hypertension (22,029 CNY).
Identifying the main factors influencing the medical expenditure of patients with T2DM can provide a reference for the medical security department to formulate reasonable compensation plans and for medical institutions to optimize treatment plans. Ultimately, this might reduce the financial burden of patients and relieve the pressure of medical insurance funds.
2型糖尿病（T2DM）是一种严重危害人类健康的慢性非传染性疾病。本研究旨在确定影响T2DM患者医疗费用的主要因素，并为医疗费用的分配和控制提供指导。
回顾性收集2011年1月至2021年12月中国西南地区6家三级医院T2DM患者的首页数据。构建多元线性回归模型，以检验与每位患者医疗费用相关的因素。此外，还描述了根据其他重要指标和患者亚组划分的医疗费用趋势，并生成了医疗费用的比例细分。所有支出数据均以人民币（CNY）为单位，基于2021年的价值，并使用特定年份的医疗消费者价格指数进行调整。
本研究共分析了45237例T2DM患者。多元线性回归显示，年龄、婚姻状况、保险类型、住院时间、门诊次数、合并症数量、疾病史、手术史、吸烟史以及年龄调整后的Charlson合并症指数评分是T2DM患者医疗费用的影响因素。考虑总体平均医疗费用，诊断费用占比最大，自2011年以来从未低于25%，呈逐年下降趋势。在合并症类型中，高血压最为常见，其次是肾脏疾病和高脂血症。在合并症组合方面，肺部感染+高血压的医疗费用最高（24360元），其次是冠心病+心力衰竭+高血压（22029元）。
确定影响T2DM患者医疗费用的主要因素，可为医保部门制定合理补偿方案以及医疗机构优化治疗方案提供参考。最终，这可能减轻患者的经济负担，缓解医疗保险基金的压力。
