安徽省六县胃癌患者住院直接医药费用及补偿水平分析
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摘要
基于新农合省级信息系统平台,抽取安徽省6个县2017年1月1日—6月30日新农合参保居民全部胃癌住院患者费用明细,统计描述直接医药费用水平、费用结构及补偿水平,评估胃癌的直接经济负担水平,为优化资源配置和制定适宜的病种付费机制提供依据。结果显示:①新农合参合居民胃癌半年住院率0.04%,住院费用占参合居民住院总费用的1.42%。②县级和省级住院人次分别占胃癌总住院人次的46.90%和41.56%。③胃癌次均住院费用11 294.31元,住院层次越高,次均住院费用越高。④药品和材料费分别占胃癌住院总费用的17.29%和22.97%,住院层次越高,药品费占比越低。⑤胃癌住院实际补偿比63.81%,贫困人口实际补偿比(91.24%)高于普通人口(60.03%)。加强县级医疗机构胃癌住院服务能力,建立有效的逐级转诊机制,有助于降低胃癌的直接经济负担水平。
To assess the level of direct economic burden of gastric cancer and provide basis for optimizing the allocation of resources and formulating the appropriate payment mechanism for diseases. We collected the details of direct medical expenses for all patients with gastric cancer from January 1 to June 30,2017 in the six counties based on the new rural cooperative provincial information system platform,and described the level of direct medical expenses,cost structure and compensation level. ①Hospitalization rate of patients with gastric cancer was 0.04% and hospitalization expenses accounted for 1.42% of the total cost of hospitalization for participant. ②The number of hospitalizations in county-level and provincial-level medical hospitals accounted for 46.90% and 41.56%,respectively. ③The average cost of hospitalization for gastric cancer per patients was11294.31 yuan. The higher the hospitalization level,the lower the cost for patients. ④Drug and material costs accounted for 17.29% and 22.97% of the total cost of hospitalization for gastric cancer respectively. The higher the level of hospitalization, the lower the proportion of drug costs. ⑤ Theactual compensation ratio for hospitalization of gastric cancer patients was 63.81%,and the actual compensation ratio for the poor population(91.24%)was higher than that of the general population(60.03%). strengthening the inpatient service capacity of gastric cancer at the county-level medical institutions and establishing an effective referral mechanism for progressive patients can effectively reduce the direct economic burden of gastric cancer.
To assess the level of direct economic burden of gastric cancer and provide basis for optimizing the allocation of resources and formulating the appropriate payment mechanism for diseases. We collected the details of direct medical expenses for all patients with gastric cancer from January 1 to June 30,2017 in the six counties based on the new rural cooperative provincial information system platform,and described the level of direct medical expenses,cost structure and compensation level. ①Hospitalization rate of patients with gastric cancer was 0.04% and hospitalization expenses accounted for 1.42% of the total cost of hospitalization for participant. ②The number of hospitalizations in county-level and provincial-level medical hospitals accounted for 46.90% and 41.56%,respectively. ③The average cost of hospitalization for gastric cancer per patients was11294.31 yuan. The higher the hospitalization level,the lower the cost for patients. ④Drug and material costs accounted for 17.29% and 22.97% of the total cost of hospitalization for gastric cancer respectively. The higher the level of hospitalization, the lower the proportion of drug costs. ⑤ Theactual compensation ratio for hospitalization of gastric cancer patients was 63.81%,and the actual compensation ratio for the poor population(91.24%)was higher than that of the general population(60.03%). strengthening the inpatient service capacity of gastric cancer at the county-level medical institutions and establishing an effective referral mechanism for progressive patients can effectively reduce the direct economic burden of gastric cancer.
引文
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[10]房珊杉,孙纽云,梁铭会.德国医疗保障体系改革及启示[J].中国卫生政策研究,2013(1):28-33
[11]范桂高.智利社会医疗保险的财政公平性[J].国外医学(卫生经济分册),2001,18(2):80-84
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[2]胡建平,饶克勤,钱军程,等.中国慢性非传染性疾病经济负担研究[J].中国慢性病预防与控制,2007,15(3):189-193
[3]人民网.安徽省发布首份肿瘤登记年报胃癌是头号“杀手”[EB/OL].[2018-05-12]. http://ah.people.com.cn/n/2014/1107/c358269-22841931.html
[4]安徽省卫生和计划生育委员会.安徽省肿瘤防治新闻通稿[EB/OL].[2018-05-12]. http://www.ahwjw.gov.cn/wjw/xwfb/xwfb/201804/9d9978c6977c4ee8b185498bd8d8ff50.html
[5]王元元,朱霖,吴晓红,等.安徽省农村贫困人口不同年龄段疾病病种基线调查[J].黑龙江医药科学,2017(3):110-112
[6]方鹏骞,苏敏.论我国健康扶贫的关键问题与体系构建[J].中国卫生政策研究,2017,10(6):60-63
[7]于德志.“保治防提”助力健康脱贫[J].中国卫生,2017(9):32-33
[8]肖梦,冯向先,张云兵,等.山西省2003—2012年胃癌患者住院费用影响因素分析[J].中国公共卫生,2015,31(10):1330-1333
[9]中华人民共和国卫生和健康委员会体制改革司.关于全面推进公立医院综合改革的通知(国卫体改发[2017]22号)[EB/OL].[2018-05-13]. http://www.nhfpc.gov.cn/tigs/s3581/201704/0563e06eff4441ffa9772dc30b4748.shtml
[10]房珊杉,孙纽云,梁铭会.德国医疗保障体系改革及启示[J].中国卫生政策研究,2013(1):28-33
[11]范桂高.智利社会医疗保险的财政公平性[J].国外医学(卫生经济分册),2001,18(2):80-84
[12]应亚珍,潘伟,张朝阳.加大保障力度,改善医疗服务公平性——新农合与医疗救助制度的衔接机制及成效分析[J].中国卫生政策研究,2015,8(11):3-8