首页|烟台市尘肺病患者医疗费用及影响因素分析

烟台市尘肺病患者医疗费用及影响因素分析

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目的 了解烟台市尘肺病患者医疗费用现状及影响因素,为采取有针对性的干预措施提供参考依据.方法 在1949-2020年烟台市诊断的职业性尘肺病现患病例数据库中按病程分层抽取300例为病例组,同性别、年龄相差≤3岁的普通人群600例为对照组.使用一般资料调查问卷对调查对象进行调查,并对数据进行分析.结果 尘肺病患者年医疗费用较对照组人群高,差异有统计学意义(P<0.05).患者年医疗费用集中在1.0万元以内,年医疗费用0~<0.2万元者占44.0%,0.2~<1.0万元者占43.0%,≥1.0万元者占13.0%.尘肺并发症、年住院天数和工伤保险均是尘肺病患者年医疗费用的主要影响因素(均P<0.05),患1种并发症的患者年医疗费用≥1.0万元的可能性是无并发症者的45.047倍,年住院天数≥20天的患者年医疗费用≥ 1.0万元的可能性是未住院患者的204.728倍,仅有工伤保险的患者年医疗费用≥1.0万元的可能性是仅有医保患者的22.728倍.康复训练是尘肺病患者年医疗费用的保护性因素(P<0.05),年康复训练时间为1~<3个月的患者年医疗费用≥ 1.0万元的可能性是未进行过康复训练者的0.016倍.结论 烟台市尘肺病患者的医疗费用明显高于普通人群,主要影响因素为尘肺并发症、年住院天数、工伤保险、康复训练.积极进行康复训练、预防尘肺并发症的发生,进一步完善工伤保险政策和康复站运行机制,可有效控制患者的医疗费用.
Analysis on medical costs and influencing factors of pneumoconiosis patients in Yantai City
Objective To explore the current situation and factors influencing medical costs of pneumoconiosis patients in Yantai City,and to provide a scientific basis for implementing targeted interventions.Methods In the database of currentcases of occupational pneumoconiosis diagnosed in Yantai City from 1949 to 2020,300 cases were stratified by disease duration as the case group,and 600 cases of the same sex and age difference of not more than 3 years were the control group.The general information questionnaire was used to survey the study population,the data was analyzed.Results Pneumoconiosis patients had higher annual medical costs than the control group population,the difference was statistically significant(P<0.05).The annual medical costs of patients were concentrated within 1.0 million yuan.The annual medical costs 0-<0.2 million yuan accounted for 44.0%of the total,0.2-<1.0 million yuan accounted for 43.0%of the total,≥1.0 million yuan accounted for 13.0%of the total.Pneumoconiosis comorbidity,annual hospitalization days and worker's injury insurance were the main factors influencing the annual medical costs of pneumoconiosis patients(all P<0.05).Patients with a comorbidity were 45.047 times more likely to have annual medical costs ≥1.0 million yuan than those without comorbidities.Patients with ≥20 days of hospitalization per year were 204.728 times more likely to have annual medical costs 1.0 million yuan than those who were not hospitalized.Patients with workers'compensation insurance only were 22.728 times more likely to have annual medical costs ≥1.0 million yuan than those with medical insurance only.Rehabilitation training was a protective factor for annual medical costs of pneumoconiosis patients(P<0.05),patients with 1-<3 months of annual rehabilitation training were 0.016 times more likely to have annual medical costs≥ 1.0 million yuan than those who had not undergone rehabilitation training.Conclusions The medical costs of pneumoconiosis patients in Yantai are significantly higher than those of the general population,the main influencing factors are pneumoconiosis comorbidity,number of days of hospitalization per year,workers'injury insurance,and rehabilitation training.Active rehabilitation training,prevention of pneumoconiosis comorbidities,and further improvement of worker's injury insurance policies and rehabilitation training operation mechanisms can effectively reduce medical costs for patients.

PneumoconiosisMedical costsInfluencing factors

米兆娟、陈超、刘薇、陈成龙、白林、阎西革

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烟台市疾病预防控制中心职业卫生科,山东烟台 264003

尘肺病 医疗费用 影响因素

烟台市科技计划

2021YD090

2024

职业与健康
天津市疾病预防控制中心 中华预防医学会

职业与健康

CSTPCD
影响因子:0.737
ISSN:1004-1257
年,卷(期):2024.40(7)
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