Abstract: Background　China owns a high hypertension incidence with relatively low control rate and cure rate，as well as long-term course.Hypertension is deemed as a major risk for health，which can lead to a series of complications，often accompanied by diabetes and other risks.Due to these characteristics of hypertension，people suffering from it have a higher risk of rehospitalization.Objective　This article was intended to analyze the prevalence and cost of repeated hospitalization in hypertension patients in Jieshou City of Anhui Province from 2016 to 2018，so as to provide clues for relieving the burden of hypertension.Methods　Data were collected from the Rural Cooperative Medical Scheme （RCMS） reimbursement system and electronic health record（EHS） system of Jieshou City of Anhui Province during February to June 2019.All the hypertensive inpatients obtaining reimbursement registered in the reimbursement system and hypertensive patients recorded in the EHS system between 2016 and 2018 were included and were analyzed to find the eligible inpatients who were also recorded in the EHS system using a computer-based program developed by our research team.The use of hospitalization services was analyzed in detail，including number of hospitalizations based on sex and age，use of local hospitals by level and of out-of-province hospitals based on sex，age，and ordinal number of hospitalizations，average length of stay and cost based on sex，age，local hospitals by level and out-of-province hospitals as well as ordinal number of hospitalizations.Results　The study included 27 092 cases from 18 townships and towns of Jieshou City with 66 008 person-times in total.From 2016 to 2018，12 536 patients （46.27%） were hospitalized once，6 071 （22.41%） were hospitalized twice，and 8 485 （31.98%） were hospitalized at least 3 times.The number of hospitalizations differed significantly by sex and age （P<0.05）.The use of local hospitals by level and of out-of-province hospitals differed significantly by sex，age，and ordinal number of hospitalizations（P<0.05）.The overall average length of stay was （8.5±6.7）d.Males had a longer average length of stay（t=5.10，P<0.05）.The average length of stay differed significantly by age（F=10.49，P<0.05），level of local hospitals and out-of-province hospitals（F= 737.92，P<0.05）.For all of them，the average total cost of hospitalization was （4 790.1±2 587.8） yuan.Among the five items listed in the NRCMS，The percentages of cost of reimbursed drugs （ratio of cost of reimbursed drugs to total hospitalization cost），reimbursed examination fee（ratio of reimbursed examination fee to total hospitalization cost），reimbursed treatment cost（ratio of treatment cost to total hospitalization cost），reimbursed cost of materials（ratio of cost of reimbursed materials to total hospitalization cost），and reimbursed surgery cost （ratio of reimbursed surgery cost to total hospitalization cost） were （29.6±16.7）%，（17.0±11.7）%，（12.9±16.2）%，（7.2±14.2）%，and （3.6±10.8）%，respectively.Males had higher percentages of reimbursed drug cost and examination fee but lower percentage of cost of reimbursed materials than females（P<0.05）.The total hospitalization cost，percentages of OOP，reimbursed drug cost，material cost，examination fee and treatment cost differed significantly by age，use of local hospitals by level and of out-of-province hospitals，as well as ordinal number of hospitalizations（P<0.05）.Conclusion　This group of hypertensive patients showed an increased risk of repeated hospitalization.The risk varied by sex，age and use of local hospitals by level and of out-of-province hospitals.The percentage of cost of reimbursed drug was highest，followed by the percentage of reimbursed examination fee.

Key words: Hypertension, Hospitalization, Repeated hospitalization, Flow directions of hospitalization, Length of stay, Hospitalization cost

摘要： 背景　高血压在我国发病率较高，控制率、治愈率较低，病程长，同时，高血压又是重大的健康危险因素，可导致一系列的并发症，又常与糖尿病等危险因素伴随发生，这些特点导致了高血压患者的重复住院情况高于一般人群。目的　分析2016—2018年安徽省界首市高血压住院患者的重复住院情况及其费用信息，为减轻高血压疾病负担提供线索。方法　2019年2—6月，收集2016—2018年安徽省界首市新型农村合作医疗（简称新农合）报销系统内所有住院患者和安徽省界首市居民电子健康档案系统内所有高血压患者的资料。采用自编程序把2016—2018年所有高血压建档居民与2016—2018年新农合报销系统内所有住院患者进行匹配合并，筛选出高血压住院患者。分析新农合报销系统内高血压患者住院服务利用情况，例如不同性别、年龄患者住院次数分布情况，不同性别、年龄、住院次序患者住院流向情况，不同性别、年龄、住院流向、住院次序患者平均住院时间，不同性别、年龄、住院流向、住院次序患者住院费用情况。结果　本研究共纳入界首市18个乡镇2016—2018年使用新农合医保报销的高血压住院患者27 092例，共66 008例次。2016—2018年，12 536例（46.27%）患者住院1次，6 071例（22.41%）患者住院2次，8 485例（31.98%）患者住院≥3次。不同性别、年龄患者住院次数分布情况比较，差异有统计学意义（P<0.05）。不同性别、年龄、住院次序患者住院流向情况比较，差异有统计学意义（P<0.05）。所有高血压住院患者平均住院时间为（8.5±6.7）d。男性高血压住院患者平均住院时间长于女性 （t=5.10，P<0.05）。不同年龄、住院流向高血压住院患者平均住院时间比较，差异有统计学意义（F值分别为10.49、737.92，P值均<0.05）。所有高血压住院患者平均住院总费用为（4 790.1±2 587.8）元。在新农合系统所列出的5个项目中，药品费占住院总费用的比例（简称药占比）为（29.6±16.7）%，检查费占住院总费用的比例（简称检查费占比）为（17.0±11.7）%，治疗费占住院总费用的比例（简称治疗费占比）为（12.9±16.2）%，材料费占住院总费用的比例（简称材料费占比）为（7.2±14.2）%，手术费占住院总费用的比例（简称手术费占比）为（3.6±10.8）%。男性高血压住院患者药占比、检查费占比高于女性，手术费占比、材料费占比低于女性（P<0.05）。不同年龄、住院流向、住院次序的高血压住院患者住院总费用、OOP占住院总费用比例、药占比、手术费占比、材料费占比、检查费占比、治疗费占比比较，差异有统计学意义（P<0.05）。结论　高血压患者重复住院概率较大，不同性别、年龄、住院流向的高血压患者重复住院情况不同；且在新农合系统所列出的各项住院费用中，以药品费为主，检查费次之。

关键词:  , 高血压, 住院, 重复住院, 住院流向, 住院时间, 住院费用