麻城市老年恶性肿瘤患者疾病经济负担影响因素分析  

Analyzing The Influencing Factors of Disease Economic Burden of The Elderly Patients with Malignant Tumors in Macheng City

作　　者：石相如[1] 王绚璇 张翔[4] 程红平[5] 周尚成 龚勋 SHI Xiang-ru

机构地区：[1]湖北省麻城市人民医院肿瘤科,湖北麻城438300 [2]湖北中医药大学临床学院 [3]湖北省肿瘤医院中西医结合科 [4]华中科技大学同济医学院医药卫生管理学院 [5]广州中医药大学经济与管理学院 [6]中安联合投资集团有限公司博士后工作站 [7]北京交通大学经济管理学院

出　　处：《中国卫生事业管理》2019年第10期751-752,776,共3页Chinese Health Service Management

基　　金：国家自然科学基金项目“应用伤残调整生命年测算疾病负担及其方法学研究——以中西部慢性病疾病负担为例”(71273083);国家自然科学基金项目“基于大数据的疾病负担测算及分析范式研究”(71774049);中国科协高端科技创新智库青年项目“互联网+背景下的‘医养融合’管理模式研究”(DXB-ZKQN-2017-043)

摘　　要：目的:分析麻城市老年恶性肿瘤患者的直接疾病经济负担及其影响因素,提出改进建议。方法:选择2015年1月-2017年12月住院治疗的1129例老年恶性肿瘤患者的住院诊疗信息作为研究对象,以住院总费用的对数作为自变量Y,患者基本信息和临床信息作为因变量X,构建多元线性回归模型,比较各变量对住院总费用的影响程度。结果:不同类型的恶性肿瘤患者人均住院费用存在差异,同种类型恶性肿瘤自费患者的人均住院费用明显低于医保患者,且差异有统计学意义(P均<0.05);呼吸系统肿瘤、消化系统肿瘤、神经系统肿瘤、泌尿生殖系统肿瘤、骨及关节肿瘤的自费患者人均住院天数明显少于医保患者,且差异有统计学意义(P均<0.05);呼吸系统肿瘤、消化系统肿瘤、神经系统肿瘤、泌尿生殖系统肿瘤、骨及关节肿瘤、造血系统肿瘤的自费患者人均药占比均明显低于医保患者,且差异有统计学意义(P均<0.05)。结论:应通过加快完善大病统筹保障和大病救助体系建设,加大医保支付比例;同时要通过提高住院诊疗服务质量,切实缩短住院天数;应重点加强呼吸系统、消化系统和神经系统恶性肿瘤的一级预防与控制,倡导健康的生活方式和饮食习惯,减少恶性肿瘤的发生率和死亡率。Objective To analyze the direct economic burden of the elderly patients with malignant tumors in Macheng City and its influencing factors, and put forward suggestions for improving it. Methods1129 cases of elderly inpatients with malignant tumors were sampled. Taken the logarithm of total hospitalization expenses as the independent variable Y, and the basic information and clinical information as the dependent variable X, a multiple linear regression model was constructed to compare the influence of each variable on the total hospitalization expenses.ResultsThe average hospitalization expenses of patients with different types of malignant tumors were different. For the same type of malignant tumors, the average hospitalization expenses of self-paying patients were significantly lower than those with medical insurance(P<0.05). For the types of respiratory system tumors, digestive system tumors, nervous system tumors, urogenital system tumors and bone and joint tumors, the average hospitalization duration of self-paying patients was significantly shorter than patients with medical insurance patients(P<0.05). And for the types of respiratory system tumors, digestive system tumors, nervous system tumors, urogenital system tumors, bone and joint tumors, and hematopoietic system tumors, the per capita proportion of drugs of self-paying patients was significantly lower than patients with medical insurance patients(P<0.05).ConclusionIt is suggested to speed up the improvement of overall insurance and rescue system for major illnesses, increase the proportion of medical insurance payment, improve the quality of inpatient diagnosis and treatment services, shorten the duration of hospitalization, especially focus on the primary prevention and control of malignant tumors in respiratory, digestive and nervous system.

关 键 词：老年人 胃癌患者 经济负担 影响因素 

分 类 号：R73[医药卫生—肿瘤]