目的:精神卫生已成为影响经济和社会发展的重大公共卫生问题,严重精神障碍(SMD)是重中之重。近年来,北京,中国,已经出台了几项政策来减轻精神健康障碍患者的经济负担。这项研究的目的是调查在引入多种医疗政策后患者医疗费用的现状和构成。探索可能影响医疗服务利用的因素,为后续政策改进提供参考和依据。
方法:多阶段抽样用于选择代表性研究人群。采用回顾性调查方法收集2019年患者信息和医疗费用数据。
方法:采用描述性统计方法分析患者医疗费用的现状,并使用两部分模型来检查影响医疗保健利用率的因素并对预测费用进行建模。
结果:在4940名参与者中,发生医疗费用的SMD患者的平均门诊费用为8373.61元,平均住院费用为81,594.05元。自付费用占门诊费用的29.22%,占住院费用的8.13%。年龄等因素,家庭地位,经济地位,婚姻状况,参与社区免费药物服务(CFMS)和诊断的疾病类型影响了医疗费用和服务利用率的差异。
结论:北京SMD患者的医疗费用较高,但是一些出台的政策有效地降低了患者的这些成本。未来的研究应关注年龄等因素的影响,经济地位,参与CFMS和医疗费用诊断的疾病类型。
OBJECTIVE: Mental health has become a significant public health problem that impacts both economic and social development, with severe mental disorders (SMDs) being the top priority. Over recent years, Beijing,
China, has introduced several policies to reduce the economic burden on patients with mental health disorders. The aim of this study was to investigate the current status and composition of patients\' medical expenses following the introduction of multiple medical policies, explore the factors that may impact the utilisation of medical services and provide a reference and basis for subsequent policy improvements.
METHODS: Multistage sampling was used to select a representative study population. A retrospective survey was used to collect patient information and data on medical expenses in 2019.
METHODS: Descriptive statistics were applied to analyse the current status of patients\' medical expenses, and a two-part model was used to examine the factors influencing healthcare utilisation and to model predicted expenses.
RESULTS: Among 4940 participants, the average outpatient expenses of patients with SMD who incurred medical expenses were 8373.61 Yuan, and the average hospitalisation expenses were 81,594.05 Yuan. The out-of-pocket expenses were 29.22% of outpatient expenses and 8.13% of inpatient expenses. Factors such as age, household status, economic status, marital status, participation in the Community Free-Medication Service (CFMS) and the type of disease diagnosed influenced the differences in medical expenses and utilisation of services.
CONCLUSIONS: The medical expenses of patients with SMD in Beijing are high, but a number of introduced policies have effectively reduced these costs for patients. Future studies should focus on the impact of factors such as age, economic status, participation in the CFMS and the type of disease diagnosed on medical expenses.