Chinese Journal of Antituberculosis ›› 2019, Vol. 41 ›› Issue (5): 556-563.doi: 10.3969/j.issn.1000-6621.2019.05.016
• Original Articles • Previous Articles Next Articles
Lin YANG1,*,Zhu NING2,Cheng CHEN3,Yi HU1,Qi ZHAO1,Hui ZHANG4,Xu-bin1 ZHENG1,Zheng-dong ZHANG2,Biao XU1()
Received:
2019-02-25
Online:
2019-05-10
Published:
2019-05-10
Contact:
Lin YANG
E-mail:bxu@shmu.edu.cn
Lin YANG,Zhu NING,Cheng CHEN,Yi HU,Qi ZHAO,Hui ZHANG,Xu-bin1 ZHENG,Zheng-dong ZHANG,Biao XU. Analysis on direct medical expenses and payment methods for smear-positive pulmonary tuberculosis outpatients in designated medical institutions—a cohort study based on tuberculosis patients in Jiangsu and Sichuan Provinces[J]. Chinese Journal of Antituberculosis, 2019, 41(5): 556-563. doi: 10.3969/j.issn.1000-6621.2019.05.016
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URL: http://www.zgflzz.cn/EN/10.3969/j.issn.1000-6621.2019.05.016
因素 | 江苏省(313例) | 四川省(117例) | 合计(430例) | 统计检验值 | P值 |
---|---|---|---|---|---|
年龄(岁)a | 48.4±22.6 | 50.6±16.8 | 49.0±21.2 | t=1.09 | 0.275 |
性别b | χ2=5.858 | 0.016 | |||
男 | 243(77.6) | 103(88.0) | 346(80.5) | ||
女 | 70(22.4) | 14(12.0) | 84(19.5) | ||
职业b | χ2=28.83 | <0.01 | |||
务农 | 181(57.8) | 62(53.0) | 243(56.5) | ||
打工/个体户 | 74(23.6) | 9(7.7) | 83(19.3) | ||
干部/职工 | 30(9.6) | 18(15.4) | 48(11.2) | ||
其他 | 28(9.0) | 28(23.9) | 56(13.0) | ||
家庭年收入(元)c | 26000.0 (6350.0,40000.0) | 3000.0 (2000.0,5000.0) | 16000.0 (4000.0,40000.0) | Z=-0.97 | <0.01 |
医保b | χ2=0.30 | 0.587 | |||
有 | 306(97.8) | 116(99.1) | 322(74.9) | ||
无 | 7(2.2) | 1(0.9) | 8(25.1) | ||
家庭灾难性卫生支出b | χ2=12.91 | <0.01 | |||
有 | 44(14.1) | 34(29.1) | 78(18.1) | ||
无 | 269(85.9) | 83(70.9) | 352(81.9) | ||
治疗类型b | χ2=2.61 | 0.106 | |||
初治 | 278(88.8) | 110(94.0) | 388(90.2) | ||
复治 | 35(11.2) | 7(6.0) | 42(9.8) | ||
治疗结局b | χ2=4.64 | 0.031 | |||
治愈或完成治疗 | 302(96.5) | 107(91.5) | 409(95.1) | ||
失败、死亡或丢失 | 11(3.5) | 10(8.5) | 21(4.9) | ||
治疗时间(月)a | |||||
治愈或完成治疗 | 6.4±1.0 | 6.2±0.7 | 6.3±1.0 | t=1.77 | 0.078 |
失败、死亡或丢失 | 6.5±2.3 | 5.8±0.6 | 6.1±1.7 | t=0.87 | 0.395 |
不良反应b | χ2=48.08 | <0.01 | |||
有 | 99(31.6) | 0(0.0) | 99(23.0) | ||
无 | 214(68.4) | 117(100.0) | 331(77.0) | ||
并发糖尿病、COPD等b | χ2=0.14 | 0.709 | |||
有 | 75(24.0) | 23(19.7) | 98(22.8) | ||
无 | 238(76.0) | 94(80.3) | 332(77.2) |
特征 | 例均直接医疗费用a | 例均自付费用a | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
检查 | 抗结核 药物 | 保肝 药物 | 其他 药物 | 合计 | 检查 | 抗结核 药物 | 保肝 药物 | 其他 药物 | 合计 | ||
地区 | |||||||||||
江苏省(313例) | 1041.0 (855.5, 1379.5) | 8.0 (8.0, 8.0) | 100.0 (44.5, 200.0) | 60.0 (0.0, 600.0) | 1609.0 (1160.5, 2534.0) | 350.0 (306.0, 410.0) | 0.0 (0.0, 0.0) | 70.0 (30.0, 150.0) | 60.0 (0.0, 600.0) | 1186.0 (829.5, 2092.0) | |
四川省(117例) | 456.0 (303.0, 678.0) | 227.0 (42.5, 578.5) | 368.0 (50.0, 1001.0) | 437.0 (42.0, 1209.5) | 1761.0 (839.5, 3052.0) | 96.8 (0.0, 322.1) | 15.8 (0.0, 242.9) | 286.0 (0.0, 951.5) | 231.1 (0.0, 1104.5) | 1302.0 (36.0, 2158.5) | |
Z值 | 12.71 | 10.70 | 6.27 | 4.30 | 0.57 | 12.94 | 13.77 | 3.40 | 2.46 | 1.98 | |
P值 | <0.01 | <0.01 | <0.01 | <0.01 | 0.571 | <0.01 | <0.01 | <0.01 | 0.014 | 0.047 | |
患者类型 | |||||||||||
初治(388例) | 955.0 (623.0, 1228.3) | 8.0 (8.0, 16.0) | 134.0 (45.0, 250.0) | 194.0 (0.0, 699.5) | 1644.5 (1086.0, 2371.5) | 599.1 (314.5, 855.8) | 0.0 (0.0, 0.0) | 100.0 (20.0, 211.5) | 100.0 (0.0, 662.0) | 1208.0 (689.0, 2085.3) | |
复治(42例) | 950.0 (581.5, 1183.8) | 8.0 (8.0, 12.0) | 100.0 (47.8, 200.0) | 169.5 (0.0, 1100.0) | 1453.5 (1008.0, 3428.8) | 611.0 (178.0, 824.0) | 0.0 (0.0, 0.0) | 100.0 (28.8, 200.0) | 104.5 (0.0, 1100.0) | 1008 (684.8, 2292.5) | |
Z值 | 0.47 | 1.25 | 0.58 | 0.44 | 0.18 | 0.40 | 0.12 | 0.19 | 0.31 | 0.04 | |
P值 | 0.648 | 0.211 | 0.563 | 0.662 | 0.861 | 0.687 | 0.904 | 0.850 | 0.756 | 0.971 | |
药物不良反应 | |||||||||||
有(99例) | 995.0 (897.0, 1347.0) | 8.0 (8.0, 9.0) | 50.0 (25.0, 60.0) | 520.0 (0.0, 1500.0) | 1777.0 (1162.0, 2934.0) | 635.0 (528.0, 925.0) | 0.0 (0.0, 0.0) | 45.0 (10.0, 60.0) | 515.5 (0.0, 1545.0) | 1328.0 (765.0, 2492.0) | |
无(331例) | 902.0 (559.0, 1152.0) | 8.0 (8.0, 67.0) | 150.0 (55.0, 300.0) | 87.0 (0.0, 600.0) | 1591.0 (1060.0, 2721.0) | 585.0 (210.0, 829.0) | 0.0 (0.0, 0.0) | 150.0 (30.0, 250.0) | 40.0 (0.0, 518.0) | 1142.0 (662.0, 1994.0) | |
Z值 | 3.94 | 3.39 | 7.22 | 4.20 | 3.94 | 3.07 | 4.72 | 6.49 | 4.88 | 1.58 | |
P值 | <0.01 | <0.01 | <0.01 | <0.01 | 0.287 | <0.01 | <0.01 | <0.01 | <0.01 | 0.115 | |
并糖尿病、COPD等慢性病 | |||||||||||
有(98例) | 1009.5 (732.5, 1278.5) | 8.0 (8.0, 12.0) | 134.0 (39.0, 250.0) | 186.0 (0.0, 663.8) | 1741.5 (1218.0, 2557.8) | 680.0 (394.5, 905.3) | 0.0 (0.0, 0.0) | 77.5 (19.5, 200.0) | 186.0 (0.0, 635.3) | 1341.0 (887.5, 2038.0) | |
无(332例) | 936.0 (588.5, 1183.8) | 8.0 (8.0, 16.0) | 122.5 (46.0, 250.0) | 194.0 (0.0, 780.0) | 1566.0 (1053.0, 2803.8) | 585.0 (281.3, 835.5) | 0.0 (0.0, 0.0) | 100.0 (20.0, 200.0) | 91.0 (0.0, 760.0) | 1152.5 (636.3, 2142.3) | |
Z值 | -2.29 | -0.43 | -0.01 | -0.59 | -1.31 | -2.17 | -0.36 | -0.13 | -0.11 | -1.26 | |
P值 | 0.022 | 0.667 | 0.993 | 0.557 | 0.191 | 0.030 | 0.722 | 0.896 | 0.914 | 0.208 | |
治疗结局 | |||||||||||
治愈或完成治疗(409例) | 954.0 (626.0, 1234.5) | 8.0 (8.0, 16.0) | 122.0 (45.5, 250.0) | 193.0 (0.0, 709.0) | 1642.0 (1066.5, 2742.0) | 607.0 (303.5, 855.5) | 0.0 (0.0, 0.0) | 100.0 (20.0, 200.0) | 100.0 (0.0, 671.8) | 1201.0 (678.0, 2110.0) | |
失败、死亡或丢失(21例) | 899.0 (563.0, 1170.5) | 8.0 (8.0, 12.0) | 150.0 (38.0, 435.0) | 195.0 (0.0, 806.5) | 1664.0 (1234.5, 2594.0) | 542.0 (284.7, 815.5) | 0.0 (0.0, 0.0) | 150.0 (25.0, 283.5) | 195.0 (0.0, 806.5) | 1103.0 (946.0, 2116.0) | |
Z值 | -0.02 | -0.19 | -0.83 | -0.06 | -0.11 | -0.17 | -0.17 | -0.63 | -0.26 | -0.08 | |
P值 | 0.988 | 0.852 | 0.404 | 0.954 | 0.913 | 0.868 | 0.865 | 0.528 | 0.795 | 0.937 | |
合计(430例) | 954.0 (620.0, 1216.8) | 8.0 (8.0, 14.5) | 122.5 (45.0, 250.0) | 194.0 (0.0, 704.5) | 1642.5 (1081.8, 2739.5) | 605.0 (299.0, 852.0) | 0.0 (0.0, 0.0) | 100.0 (20.0, 200.0) | 100.0 (0.0, 668.5) | 1197.0 (954.0, 1216.8) |
检查项目 | 治疗前 | 治疗期间 | 全程 | |||
---|---|---|---|---|---|---|
总费用 | 人均费用( | 总费用 | 人均费用( | 总费用 | 人均费用( | |
诊疗服务包内基本检查服务 | ||||||
涂片 | 16158 | 41.2±9.5 | 45408 | 136.8±43.7 | 61566 | 147.6±74.2 |
胸片 | 28973 | 60(60.0,87.0)a | 40610 | 147.7±75.8 | 69583 | 135.4±70.0 |
血常规 | 5240 | 25.2±3.5 | 17192 | 53.6±32.0 | 22432 | 59.8±34.1 |
尿常规 | 77 | 11.0±0.0 | 220 | 13.8±6.4 | 297 | 14.1±6.2 |
肝功能 | 13950 | 58.9±6.3 | 54724 | 156.4±80.8 | 68674 | 173.5±87.9 |
肾功能 | 2700 | 27.3±9.7 | 6080 | 49.4±32.3 | 8780 | 55.0±36.2 |
血糖 | 10 | 10.0±0.0 | 20 | 20.0±0.0 | 30 | 15.0±7.1 |
心电图 | 25 | 25.0±0.0 | 0 | 25 | 25.0±0.0 | |
合计 | 67133 | 130.0(105.0,170.0)a | 164254 | 373.5(305.0,520.0)a | 231387 | 468.5(360.0,620.0)a |
诊疗服务包外检查服务 | ||||||
痰培养 | 18803 | 49.1±6.8 | 955 | 45.5±12.8 | 19758 | 50.8±17.9 |
胸部X线透视 | 873 | 109.1±34.3 | 15326 | 163.1±53.6 | 16199 | 0.0(0.0,97.0)* |
CT | 61138 | 404.9±55.6 | 34539 | 605.9±301.1 | 95677 | 517.0±278.5 |
血红细胞沉降率 | 252 | 6.0±0.0 | 300 | 7.9±4.0 | 552 | 8.2±4.2 |
B超 | 30 | 30.0±0.0 | 30 | 30.0±0.0 | 60 | 30.0±0.0 |
结核菌素皮肤试验 | 28200 | 200.0±0.0 | 0 | 28200 | 200.0±0.0 | |
乙肝五项检查 | 1736 | 28.9±1.0 | 254 | 28.2±0.7 | 1990 | 28.9±1.0 |
其他 | 324687 | 64.2(6.0,381.5)a | 7201 | 42.7(15.3,140.0)a | 331888 | 122.0(30.0,459.5)a |
合计 | 435719 | 250.0(113.9,447.0)a | 58605 | 194.0(58.2,301.6)a | 494324 | 310.0(244.0,644.0)a |
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