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目的了解单病种定额付费政策下,肺结核患者的直接医疗费用及构成,为完善结核病控制政策、优化资源配置提供依据。方法采用系统抽样方法,在湖北省抽取了实行单病种定额付费政策某市的3个县市区内的共81例全程完成治疗疗程的初治涂阳肺结核病患者进行定量问卷调查,系统收集医疗费用等方面的数据,对患者的住院天数、住院医疗费用构成进行分析。结果肺结核病患门诊医疗费用均数为1 935元,中位数为2 008元,住院医疗费用均数为5 663元,中位数为4 358元,不同地区患者医疗费用差异有统计意义;3个地区县市区医疗费用的报销率平均在70%以上。西药费和诊断费是医疗费用的重要组成部分。结论在目前的筹资和支付水平上,该市的初治涂阳肺结核病患者的西药费和诊断费是医疗费用的重要组成部分。应该通过相应的医保政策来保障该人群的最主要的医疗过程。该市肺结核患者医疗费用水平在全国处于中等水平,且地区差异较大,但整体报销率高于其他地区,大大减轻了患者的医疗负担。
Objective To understand the direct medical costs and composition of patients with tuberculosis under the single-patient fixed-pay policy, and provide the basis for improving TB control policies and optimizing the allocation of resources. Methods A total of 81 cases of newly diagnosed smear-positive pulmonary tuberculosis patients who completed the treatment course in three counties and cities in a certain city in Hubei province were sampled by systematic sampling method in Hubei Province. Quantitative questionnaires were collected and systematically collected Medical expenses and other aspects of the data, the patient’s hospital days, hospital medical expenses constitute an analysis. Results The outpatient medical costs of tuberculosis patients were 1 935 yuan, with a median of 2 008 yuan. The average number of hospitalization expenses was 5 663 yuan, with a median of 4 358 yuan. There was statistically significant difference in medical expenses among patients in different regions. The reimbursement rates of medical expenses in three districts and counties average more than 70%. Western medicine costs and diagnostic fees are an important part of medical expenses. Conclusions At the current level of funding and disbursement, Western fees and diagnostic fees for newly diagnosed smear-positive TB patients in the city are an important part of the medical costs. The most important medical course of the population should be ensured through appropriate health insurance policies. The city’s tuberculosis patients medical costs in the country at a medium level, and large differences in the region, but the overall reimbursement rate is higher than in other regions, greatly reducing the patient’s medical burden.