2014-2016年河北省保定市肺癌住院病人费用分析
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摘要
目的分析2014-2016年保定市肺癌病人的住院费用,为下一步卫生决策提供参考依据。方法采用整群随机抽样方法,抽取保定市两所三级综合医院,收集2014-2016年肺癌病例资料,采用秩和检验分析不同人群及不同年份的次均住院费用、日均住院费用及住院天数的变化。结果 2014-2016年保定市城职人员的次均住院费用(P=0. 000)及日均住院费用(P=0. 000)均高于农民。次均住院费用的年均增长率总人群为3. 59%、农民为9. 31%,城职人员3年费用未见增长。日均住院费用的年均增长率,总人群为11. 44%,农民为12. 15%,城职人员为8. 14%。总人群次均住院费用中,药费占53. 16%,其次分别为治疗费11. 95%、化验费10. 12%、卫生材料费9. 67%、检查费8. 43%,护理费最低,为0. 30%。城职人员的次均住院天数多于农民(P=0. 000)。结论农民肺癌病人的经济负担较城职人员更重,肺癌住院病人的费用需在总量控制的基础上,继续降低药占比,防止化验费、卫生材料费的不合理增长。
Objective This paper provides reference for future health insurance policies by analyzing the hospitalization expenses of patients with lung cancer from 2014 to 2016 in Baoding. Methods Using cluster random sampling method,the data of all lung cancer patients in two tertiary general hospitals in Baoding from 2014 to 2016 was collected,and the changes of average hospitalization expenses,average daily hospitalization expenses and the length of stay of different populations and years were analyzed by rank-sum test. Results The average hospitalization expenses(P = 0. 000) and average daily hospitalization expenses(P = 0. 000) of urban staff were higher than those of peasants. The average annual growth rate of hospitalization expenses was3. 59% for the total population and 9. 31% for the peasants. The average annual growth rate of daily hospitalization expenses was11. 44% for the total population,12. 15% for peasants and 8. 14% for urban staff. Among the average hospitalization fees of the total population, the drug fee accounted for 53. 16%, followed by treatment fee of 11. 95%, laboratory fee of 10. 12%,sanitary materials fee of 9. 67%,inspection fee of 8. 43%,and nursing fee of 0. 30%. The hospitalization days of urban staff was higher than that of peasants(P = 0. 000). Conclusion The financial burden of of rural lung cancer patients is heavier than that of urban staff. We should continue to reduce the proportion of medicine on the basis of total control,and prevent the unreasonable increase of laboratory fee and sanitary material fee.
Objective This paper provides reference for future health insurance policies by analyzing the hospitalization expenses of patients with lung cancer from 2014 to 2016 in Baoding. Methods Using cluster random sampling method,the data of all lung cancer patients in two tertiary general hospitals in Baoding from 2014 to 2016 was collected,and the changes of average hospitalization expenses,average daily hospitalization expenses and the length of stay of different populations and years were analyzed by rank-sum test. Results The average hospitalization expenses(P = 0. 000) and average daily hospitalization expenses(P = 0. 000) of urban staff were higher than those of peasants. The average annual growth rate of hospitalization expenses was3. 59% for the total population and 9. 31% for the peasants. The average annual growth rate of daily hospitalization expenses was11. 44% for the total population,12. 15% for peasants and 8. 14% for urban staff. Among the average hospitalization fees of the total population, the drug fee accounted for 53. 16%, followed by treatment fee of 11. 95%, laboratory fee of 10. 12%,sanitary materials fee of 9. 67%,inspection fee of 8. 43%,and nursing fee of 0. 30%. The hospitalization days of urban staff was higher than that of peasants(P = 0. 000). Conclusion The financial burden of of rural lung cancer patients is heavier than that of urban staff. We should continue to reduce the proportion of medicine on the basis of total control,and prevent the unreasonable increase of laboratory fee and sanitary material fee.
引文
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[17]黄利娟,梁学柱,查君敬.基于BP神经网络的肺癌手术患者住院费用影响因素分析[J].中国病案,2014,15(6):53-55.
[2] WANQING C,RONGSHOU Z,PETER D,et al. Cancer statistics in China,2016[J]. A Cancer Journal for Clinicians,2016,66(2):115-132.
[3]保定市统计局.保定市2016年国民经济和社会发展统计公报[Z]. 2016-06-25.
[4]周彩虹,张力建,熊洪超,等.肿瘤专科医院肺癌住院费用及相关因素的回顾调查分析[J].中国医院管理,2010,30(7):37-40.
[5]李亚运,钱东福,周守君,等.某地区肺癌住院患者直接经济负担城乡差异比较研究[J].重庆医学,2016,45(5):661-663.
[6]石春雷,娄培安,董宗美,等.徐州市三级综合医院2007-2013年肺癌患者住院费用分析[J].中华肿瘤防治杂志,2017,24(17):1183-1189.
[7]肖倩,武晓猛,张龙,等.不同级别医院城乡参保和参合居民患者住院医疗费用的对比研究[J].现代预防医学,2015,41(17):3147-3160.
[8]宋荣梅,丁国武.不同级别医疗机构中参合农民的住院费用分析[J].中国卫生事业管理,2010,27(3):191-206.
[9]赵少峰,吕红亮,彭映姝,等.肺癌患者住院费用影响因素分析—以四川省某三甲医院为例[J].预防医学情报杂志,2015,30(5):342-345.
[10]鲍晓蕾,胡良平,陈韬.甘肃省2778例肺癌患者住院费用影响因素分析[J].军事医学,2016,39(11):838-841.
[11]董佩,毛阿燕,邱五七,等.北京市6种癌症住院费用回顾性分析[J].中国医院管理,2016,35(5):35-37.
[12]左学金,胡苏云.城镇医疗保险制度改革:政府与市场的作用[J].中国社会科学,2001,22(5):102-111.
[13]蔡玥,严宝湖,周恭伟. 2011-2015年中国肺癌直接经济负担及次均费用分析[J].中国卫生统计,2018,35(3):334-337.
[14] STAHEL R,BOGAERTS J,CIARDIELLO F,et al. Optimising translational oncology in clinical practice:strategies to accelerate progress in drug development[J]. Cancer Treat Rev,2016,41(2):129-135.
[15]孙义峰.某公立医院2010年-2016年住院医疗费用结构变动情况分析[J].中国病案,2017,18(3):50-52.
[16]柳俊杰,马雷,李军,等.某市医保恶性肿瘤患者住院费用分析[J].医学与哲学,2017,38(16):90-93.
[17]黄利娟,梁学柱,查君敬.基于BP神经网络的肺癌手术患者住院费用影响因素分析[J].中国病案,2014,15(6):53-55.