Objective: To analyze the hospitalization cost and its influencing factors of imported malaria patients in Guangxi Zhuang Autonomous Region and Yunnan Province, so as to provide insights into the evaluation of the economic burden due to imported malaria, and the guiding of malaria control and the rational allocation of medical resources.
Methods: The data pertaining to the hospitalization costs of imported malaria patients admitted to Shanglin County People's Hospital in Guangxi Zhuang Autonomous Region during the period from January 1 through December 31, 2019, and Tengchong Municipal People's Hospital in Yunnan Province from January 1, 2015 to December 31, 2019, were collected, and the epidemiological data of these imported malaria patients were extracted from the Information Management System for Parasitic Diseases Control and Prevention, China. The composition of the hospitalization expenses was analyzed using a descriptive method. In addition, the factors affecting the hospitalization expenses of imported malaria patients were identified using a univariate analysis and a recursive system model.
Results: A total of 206 imported malaria patients were included in this study, including 194 men (94.17%) and 12 women (5.83%). The mean length of hospital stay was 5.00 days per patient and the median hospitalization expenses were 2 813.07 Yuan per time, in which the expenses for laboratory examinations were the highest (45.31%, 1 274.62/2 813.07). Univariate analysis showed that hospital (z = 5.43, P < 0.01), type of malaria (χ2 = 34.86, P < 0.01) and type of payment (χ2 = 7.72, P < 0.05) were factors affecting the hospitalization expenses of imported malaria patients. Recursion system modeling revealed that the total effects on hospitalization expenses of imported malaria patients included length of hospital stay (0.78), selection of hospital (0.34), basic medical insurance for urban and rural residents (0.19), new rural cooperative medical care (0.17), Plasmodium falciparum malaria (0.15), gender (0.11) and P. vivax malaria (0.09).
Conclusions: The hospitalization expenses of imported malaria patients are affected by multiple factors in Guangxi Zhuang Autonomous Region and Yunnan Province, in which the length of hospital stay is the most predominant influencing factor. A reduction in the length of hospital stay is effective to decrease the hospitalization expenses of imported malaria patients.
［摘要］ 目的 对广西壮族自治区和云南省输入性疟疾病例住院费用及其影响因素进行分析, 为评价输入性疟疾导致 的经济负担、进而指导疟疾防控并合理配置医疗资源提供参考。方法 分别收集2019年1月1日—12月31日在广西壮族自治区上林县人民医院、2015年1月1日—2019年12月31日在云南省腾冲市人民医院就诊的输入性疟疾患者住院费 用信息, 并从中国寄生虫病防治信息管理系统提取上述病例流行病学个案资料。采用描述性方法对住院费用构成进行分析, 应用单因素分析及递归系统模型对患者住院费用的相关影响因素进行分析。结果 共纳入输入性疟疾患者206例, 其中男性194例 (94.17%), 女性12例 (5.83%) ; 人均住院时长5.00 d; 次均中位住院费用2 813.07元, 其中化验费占比 最高 (45.31%, 1 274.62元/2 813.07元) 。单因素分析显示, 医院 (z = 5.43, P < 0. 01) 、疟疾种类 (χ2 = 34.86, P < 0.01) 和付 费方式 (χ2 = 7.72, P < 0.05) 是输入性疟疾患者住院费用的影响因素。递归系统模型分析显示, 输入性疟疾患者住院费用 影响因素按总效应值由大到小排序依次为：住院时长 (0.78) 、选择医院 (0.34) 、城乡居民基本医疗保险 (0.19) 、新型农村 合作医疗保险 (0.17) 、恶性疟 (0.15) 、性别 (0.11) 和间日疟 (0.09) 。结论 广西壮族自治区和云南省输入性疟疾患者住院 费用受多种因素影响, 其中住院时长是最主要的影响因素。通过适当缩短住院治疗时长, 可有效控制输入性疟疾患者住 院费用。.
Keywords: Guangxi Zhuang Autonomous Region; Hospitalization expense; Imported malaria; Influencing factor; Recursive system model; Yunnan Province.