Prescription cost analysis and influencing factors for diabetes mellitus outpatients of public hospitals in Gansu Province
Objective To analyze the prescription cost changes and their influencing factors for outpatients with diabetes mellitus in public hospitals in Gansu Province from 2019 to 2022,providing a reference for effective prescription cost control costs.Methods The prescription data for diabetes outpatients from three public hospitals in Gansu Province were collected from 2019 to 2022.Nonparametric rank sum test,multiple linear regression,and random forest regression tree models were utilized to analyze the prescription cost and its influencing factors the software used was SPSS 25.0 and R 3.6.0.Results A total of 410 142 prescriptions of diabetes outpatients were collected.The single prescription costs for diabetes outpatients were predominately in the 100-＜500 yuan range,with an average cost of 513.71 yuan,increasing from 484.52 yuan in 2019 to 539.17 yuan in 2022.The proportion of prescriptions costing less than 100 yuan rose from 21.91％in 2019 to 39.05％in 2022,while the proportion of prescriptions costing 500 yuan or more decreased from 23.35％in 2019 to 20.10％in 2022.Univariate analysis showed significant differences in by medical institution level,year,gendar,age,diagnosis type,presence of complications,number of prescribed drugs,and presence of injections(all P＜0.05).Multiple linear regression analysis identified factors including medical institution level(provincial level as reference,municipal β=-2.958,and county level β=-2.953),year(with 2019 as reference,2020 β=-0.122,2021 β=-0.216,2022β=-0.239),gender(β=-0.048),age(0-＜45 years as the reference,45-＜65 years β=0.072,≥65years β=0.020),diagnostic type(type Ⅰ diabetes as a reference,type Ⅱ diabetes β=0.204,other diagnostic types β=0.016),presence of complications(β=0.096),number of medications(β=0.457),and presence of injections(β=-0.817)as significant influencing factors on prescription costs(P＜0.05).The Random Forest Regression Tree model highlighted the number of medications,presence of injections,medical institution level and year as the top four influencing factors.Conclusions Prescription costs for diabetes outpatients in Gansu Province are relatively is high,necessitating further optimization of the treatment plans efforts should be made to promote hierarchical medical care,implement diabetes-specific hierarchical diagnosis and treatment initiative,rationalize medicines prescription numbers,prioritize the use of centrally procured medications,and alleviated the economic burden on patients.
Diabetes mellitusPrescription costsInfluencing factorsMultiple linear regressionRandom forest
NETL
NSTL
万方数据
