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目的了解北京地区腹主动脉瘤患者的诊疗及相关费用情况,并对腹主动脉瘤住院和门诊患者的费用构成及年均疾病花费情况进行分析。方法利用北京市城镇职工基本医疗保险信息系统数据库,采用数据挖掘的方法,从数据库中提取2005-2012年诊断为腹主动脉瘤的所有患者的相关信息进行系统整理分析。结果 1共纳入腹主动脉瘤患者763人(1 197人次),其中住院患者434人(479人次),门诊患者329人(718人次)。2住院患者次均花费98 502元,其中材料费所占比例达59.02%,其次为检查治疗费和药费,床位费用所占比例最低。3门诊患者次均就诊费用614元,其中药费所占比例达59.59%,其次是检查治疗费、材料费。合并其他疾病的患者药费显著高于无合并症患者(P<0.000 1)。4住院患者年均花费104 617元,手术治疗的住院患者年均花费154 144元,非手术治疗的住院患者年均花费24 774元。门诊患者年均就诊次数为1.61次,年均花费1 257元,无合并症门诊患者年均花费1 198元,有合并症多次就诊的门诊患者年均花费2 741元。结论腹主动脉瘤住院患者的费用构成中材料费所占比例较大。应进一步采取综合措施,降低腹主动脉瘤患者的诊疗费用,使患者能够获得更好的效价比。
Objective To understand the diagnosis and treatment of abdominal aortic aneurysm in Beijing and related costs, and to analyze the cost structure and annual average expenditure of patients with abdominal aortic aneurysm in hospital and outpatients. Methods Based on the database of basic medical insurance information system for urban workers in Beijing, the data of all patients diagnosed as abdominal aortic aneurysm from 2005 to 2012 were extracted from the database and analyzed systematically. Results A total of 763 patients (1,197) with abdominal aortic aneurysm were included, including 434 hospitalized patients (479) and 329 outpatients (718). 2 Inpatients spent an average of 98 502 yuan, of which material costs accounted for 59.02%, followed by examination of treatment and drug costs, the lowest proportion of bed costs. Outpatient visits cost 614 yuan, of which 59.59% share of the proportion of medicine, followed by examination of treatment costs, materials costs. Medication costs were significantly higher in patients with other diseases than those without complications (P <0.000 1). 4 Inpatients spent an average of 104 617 yuan per year on average. Inpatients undergoing surgery were spending an average of 154 144 yuan per year, while non-surgical inpatients spent 24 774 yuan on average each year. The outpatients received an average of 1.61 visits each year, with an average annual cost of 1,257 yuan. Patients without complications had an annual average cost of 1,198 yuan. Outpatients with complications of multiple visits spent an average of 2,741 yuan per patient. Conclusion The cost of hospitalization of patients with abdominal aortic aneurysm constitutes a large proportion of material costs. Should take further comprehensive measures to reduce the cost of diagnosis and treatment of patients with abdominal aortic aneurysm, so that patients can get a better price to performance ratio.