口服降糖药治疗的2型糖尿病患者医疗资源利用与医疗费用调查研究

吴晶,纪立农,郭连雨,钟国连

中国药学杂志 ›› 2014, Vol. 49 ›› Issue (15) : 1369-1372.

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中国药学杂志 ›› 2014, Vol. 49 ›› Issue (15) : 1369-1372. DOI: 10.11669/cpj.2014.15.023
药事管理

口服降糖药治疗的2型糖尿病患者医疗资源利用与医疗费用调查研究

  • 吴晶1,纪立农2,郭连雨3,钟国连4
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Health Care Utilization and Medical Expenditures of Type 2 Diabetes Patients Treated with Oral Anti-Diabetic Drugs

  • WU Jing1, JI Li-nong2, GUO Lian-yu3, ZHONG Guo-lian4
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摘要

目的 了解我国仅接受口服降糖药治疗且血糖控制不佳的2型糖尿病患者医疗资源利用和医疗费用情况。方法 2008年12月至2009年7月在全国9所城市75家医院对仅接受口服药治疗且血糖控制不佳的2型糖尿病患者进行问卷调查,调查患者的社会经济、疾病状态、医疗资源利用以及医疗费用信息,统计患者的年门诊次数、住院次数、门诊费用、住院费用、降糖药费用以及患者用药的依从性状况,并在不同并发症患者间进行比较。结果 回收有效问卷5 066份。患者年均门诊次数为14.23次,住院次数为0.70次,按医嘱服药的患者比例为50.59%。患者年均医疗费用为9 977.63元,其中年门诊费用6 002.35元(60.15%),年降糖药费用达4 298.61元(43.08%)。有并发症的患者年门诊15.04次、年住院0.75次,年均医疗费用为10 946.69元,年降糖药费用为4 589.18元,均显著高于无并发症的患者(P=0.000 0)。不同并发症类别中,合并心脏病的患者年门诊次数最多(18.01次),合并肾脏疾病的年住院次数最多(1.49次),合并糖尿病足的年均医疗费用、年降糖药费用最高(18 341.47元、6 197.96元)。结论 仅接受口服降糖药治疗且血糖控制不佳的2型糖尿病患者经济负担较重,有并发症的患者面临更高的经济压力。在各类并发症中,以合并糖尿病足的患者经济负担最重。应有效控制患者病情,尽量避免并发症的产生,并对糖尿病足的患者给予更多地社会关注。

Abstract

OBJECTIVE To understand health care utilization and medical expenditures of type 2 diabetes patients poorly-controlled with oral anti-diabetic drugs (OADs) in China. METHODS A nationwide survey was conducted in type 2 diabetes patients poorly-controlled with OADs in 75 hospitals in 9 cities from December 2008 to July 2009. Annual number of outpatient visits, number of hospitalizations, total medical cost, OAD cost, and percentage of patients taking OADs according to the instructions were calculated. RESULTS A total of 5 066 valid questionnaires were collected. The number of outpatient visits and hospitalizations per patient per year were 14.23 and 0.70, respectively. 50.59% of patients reported taking OADs according to the instructions. Total medical cost was 9 977.63 Yuan per patient per year, with outpatient cost accounting for 60.15% (6 002.35), and OADs accounting for 43.08% (4 298.61). On average, the annual number of outpatient visits was 15.04, the number of hospitalizations was 0.75, total medical cost was 10 946.69 Yuan, and OAD cost was 4 589.18 Yuan for one patient with complications, and all these four indicators were higher than those for patients without complications. Patients with heart diseases have the biggest number of outpatient visits, and patients with kidney disease have the biggest number of hospitalizations. Patients with foot complications have the largest amount of total medical cost (18 341.47 Yuan) and OAD cost (6 197.96 Yuan). CONCLUSION Heavy economic burdens were seen for type 2 diabetes patients poorly-controlled with OADs in China, especially for the patients with foot complications. Measures should be taken to improve diabetes management and prevent diabetes-related complications. More attention should be paid to patients with foot complications.

关键词

2型糖尿病 / 口服降糖药 / 医疗资源利用 / 医疗费用

Key words

type 2 diabetes / OADs / health care utilization / medical expenditures

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吴晶,纪立农,郭连雨,钟国连. 口服降糖药治疗的2型糖尿病患者医疗资源利用与医疗费用调查研究[J]. 中国药学杂志, 2014, 49(15): 1369-1372 https://doi.org/10.11669/cpj.2014.15.023
WU Jing, JI Li-nong, GUO Lian-yu, ZHONG Guo-lian. Health Care Utilization and Medical Expenditures of Type 2 Diabetes Patients Treated with Oral Anti-Diabetic Drugs[J]. Chinese Pharmaceutical Journal, 2014, 49(15): 1369-1372 https://doi.org/10.11669/cpj.2014.15.023
中图分类号: R956   

参考文献

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