摘要
目的探讨真实世界中终末期肾病患者血液透析与腹膜透析的直接医疗费及其影响因素,从而为政策制订提供证据支持。方法回顾性分析2015年中国医疗保险研究会城镇参保患者数据库中透析患者资料。根据纳排标准,纳入血液透析患者2655例,腹膜透析患者360例。采用1∶1倾向评分匹配法平衡组间基本资料不均衡的变量并获得匹配患者,采用多元线性回归法分析直接医疗费影响因素。结果采用倾向评分匹配后获得透析患者584例,血液透析年人均直接医疗费显著高于腹膜透析(P<0.05)。多元线性回归分析显示,贫血、高血压、透析方式、糖尿病、区域和血脂异常是影响直接医疗费的重要因素(P<0.05)。结论终末期肾病患者腹膜透析直接医疗费低于血液透析,主要影响因素是合并症和区域,为减轻社会经济负担,应调整支付方式,将腹膜透析液从药占比中剔除,促进腹膜透析技术的推广。
Objective To investigate the direct medical expenses of hemodialysis and peritoneal dialysis in patients with end-stage renal disease in the real world and their influencing factors,so as to provide evidence support for policy formulation.Methods The data of dialysis patients in the urban insured patients database of China Health Insurance Research Association in 2015 was retrospectively analyzed.According to the inclusion and exclusion criteria,2655 hemodialysis patients and 360 peritoneal dialysis patients were included.The 1∶1 propensity score matching method was used to balance the variables with imbalanced basic data between the groups and obtain matched patients,and multiple linear regression method was used to analyze the influencing factors of direct medical expenses.Results After propensity score matching,584 dialysis patients were acquired,and the annual per capita direct medical expenses of hemodialysis were significantly higher than that of peritoneal dialysis(P<0.05).Multiple linear regression analysis showed that anemia,hypertension,dialysis mode,diabetes,regional and dyslipidemia were important factors affecting the direct medical expenses(P<0.05).Conclusion The direct medical expenses of peritoneal dialysis in patients with end-stage renal disease is lower than hemodialysis,the main influencing factors are complications and regions,in order to reduce the social and economic burden,payment mode should be adjusted to eliminate peritoneal dialysis fluid from drug proportion,promoting the promotion of peritoneal dialysis technology.
作者
聂晨
高双庆
陈金榆
张方
NIE Chen;GAO Shuangqing;CHEN Jinyu;ZHANG Fang(School of Business Administration,Shenyang Pharmaceutical University,Liaoning Province,Shenyang110016,China;Beijing Medical Health Economics Research Centre of North China,Beijing100021,China)
出处
《中国医药导报》
CAS
2019年第24期59-61,66,共4页
China Medical Herald
基金
辽宁省教育厅高校基本科研项目(2017WFW05)
关键词
终末期肾病
腹膜透析
血液透析
直接医疗费
倾向评分匹配
多元线性回归
End-stage renal disease
Peritoneal dialysis
Hemodialysis
Direct medical expenses
Propensity score matching
Multiple linear regression
