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目的:本研究基于“卫生费用核算体系2011”(SHA 2011)核算天津市老年人慢性病治疗服务费用。方法:基于SHA 2011核算框架核算2012年天津市老年人慢性病治疗费用总量、不同疾病治疗费用、人群费用分布和机构流向。结果:2012年天津市老年人治疗费用总量为150.08亿元,其中,慢性病占91.37%;费用最高的前四种慢性病依次为循环系统疾病、内分泌、营养和代谢疾病、肿瘤和呼吸系统疾病;60~64岁年龄组慢性病治疗总费用最高,80岁及以上组人均治疗费用最高;医院和基层医疗机构慢性病治疗费用总量相近,其中,医院以住院服务为主,基层医疗机构以门诊服务为主。结论:慢性病消耗了绝大部分老年人治疗资源;天津市基层医疗卫生机构较好的能力建设确保老年人群具有比较合理的就医流向。
OBJECTIVE: This study accounts for the treatment of chronic diseases in the elderly in Tianjin based on the “Health Expenses Accounting System 2011” (SHA 2011). Methods: Based on the SHA 2011 accounting framework, the total cost of treating chronic diseases in the elderly in Tianjin in 2012, treatment costs of different diseases, population cost distribution and institutional flow were calculated. Results: The total cost of treatment for the elderly in Tianjin was 15,080 million yuan in 2012, of which chronic diseases accounted for 91.37%. The top four chronic diseases with the highest cost were circulatory system diseases, endocrine diseases, nutrition and metabolic diseases, tumor and respiratory diseases, The total cost of chronic diseases in the 60-64 age group was the highest, while that of the patients in the 80-year-old group and above group was the highest. The total cost of treating chronic diseases was similar in the hospitals and primary-level medical institutions. Among them, hospital-based hospital services were the mainstay, the Lord. Conclusion: Chronic diseases have consumed most of the treatment resources for the elderly. The better capacity-building of primary health care institutions in Tianjin ensures that older people have a reasonable medical treatment flow.