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(fèi)用情況，為制定合理醫(yī)療政策，減輕社會(huì)及患者負(fù)擔(dān)提供證據(jù)支持。方法 選取2012-2013年天津市城鎮(zhèn)職工基本醫(yī)療保險(xiǎn)參保人30%隨機(jī)抽樣數(shù)據(jù)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(gè)月）和隨訪期（12個(gè)月）內(nèi)均持續(xù)參保的患者為研究對(duì)象。統(tǒng)計(jì)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(fèi)用構(gòu)成，并通過廣義線性回歸分析患者醫(yī)療費(fèi)用的影響因素。結(jié)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(shù)為（1.72±1.63）。19.0%的患者因急性冠脈綜合征有過住院經(jīng)歷，年均住院次數(shù)為（1.32±0.72）次，次均住院天數(shù)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(jīng)歷，年人均門診次數(shù)為（13.05±10.18）次?；颊吣昃t(yī)療總費(fèi)用為（7 435±16 039）元，其中所占比例最高的分別是藥品費(fèi)用（53.3%）、醫(yī)療耗材費(fèi)用（26.7%）和檢查費(fèi)用（10.2%）。回歸結(jié)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(fèi)用的主要因素。結(jié)論 急性冠脈綜合征患者醫(yī)療費(fèi)用較高，應(yīng)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(jīng)濟(jì)負(fù)擔(dān)。

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.