目的 研究急性冠脈綜合征患者的醫(yī)療資源使用與醫(yī)療費用情況，為制定合理醫(yī)療政策，減輕社會及患者負擔提供證據支持。方法 選取2012-2013年天津市城鎮(zhèn)職工基本醫(yī)療保險參保人30%隨機抽樣數據庫中至少1次以急性冠脈綜合征為主要診斷的住院記錄，年齡≥ 18周歲，基線期（12個月）和隨訪期（12個月）內均持續(xù)參保的患者為研究對象。統計基線期患者基本特征、隨訪期患者疾病特異的醫(yī)療資源使用及醫(yī)療費用構成，并通過廣義線性回歸分析患者醫(yī)療費用的影響因素。結果 14 358名患者納入本研究中，患者平均年齡為（64.69±10.72）歲，54.6%為男性，80.6%處于退休狀態(tài)?；颊卟鞝柹喜Y指數為（1.72±1.63）。19.0%的患者因急性冠脈綜合征有過住院經歷，年均住院次數為（1.32±0.72）次，次均住院天數為（10.47±7.76）d。88.5%的患者因急性冠脈綜合征有過門診治療經歷，年人均門診次數為（13.05±10.18）次?；颊吣昃t(yī)療總費用為（7 435±16 039）元，其中所占比例最高的分別是藥品費用（53.3%）、醫(yī)療耗材費用（26.7%）和檢查費用（10.2%）?；貧w結果顯示年齡、性別、基線合并癥及治療方式是影響患者總醫(yī)療費用的主要因素。結論 急性冠脈綜合征患者醫(yī)療費用較高，應采取有效措施降低急性冠脈綜合征發(fā)生，制定合理醫(yī)療政策，從而減輕患者的經濟負擔。

Objective To study the utilization of medical resources and medical expenses of patients with acute coronary syndrome in order to provide evidence for formulating reasonable medical policies and reducing the burden of society and patients. Methods The subjects were selected from a random sampling database of 30% of urban employees' basic medical insurance insured in Tianjin from 2012 to 2013, which included at least one hospitalization record with acute coronary syndrome as the main diagnosis. The patients were over 18 years old, with continuous participation in the baseline (12 months) and follow-up (12 months). The basic characteristics of patients in the baseline period, the use of disease-specific medical resources and the composition of medical expenses in the follow-up period were analyzed. The influencing factors of patients' medical expenses were analyzed by generalized linear regression. Results A total of 14 358 patients were included, with mean age of (64.69 ±10.72) years and 45.4% female, and 80.6% patients were retired. Charlson Comorbidity Index was (1.72 ±1.63). 19.0% of patients had hospitalization experience due to acute coronary syndrome. And the average number of hospitalizations per year was (1.32 ±0.72) times, and the average number of hospitalization days per time was (10.47 ±7.76) d. 88.5% of patients had experience of outpatient treatment for acute coronary syndrome, and the average number of outpatient visits per year was (13.05 ±10.18) times. The average annual total medical expenses of patients with acute coronary syndrome were (7 435 ±16 039) CNY. Among them, the highest proportion was drug expenses (53.3%), medical consumables costs (26.7%) and inspection costs (10.2%). The regression results showed that age, sex, baseline complications and treatment methods were the main factors affecting the total medical expenses of patients with acute coronary syndrome. Conclusions Cost for patients with acute coronary syndrome was considerable. Effective measures should be taken to reduce the occurrence of acute coronary syndrome, and reasonable medical policies should be formulated to alleviate the economic burden of patients.