2013—2017年我国四种恶性肿瘤住院费用水平及结构变动度分析  

Hospitalization Cost and Its Structural Variation for Four Kinds of Malignant Tumors in China from 2013 to 2017

作　　者：宋燕楠 尹文强[1,2,3] 刘敏 李秋莎 刘倩 黄亚男[1,2,3] 许小凤 黄冬梅[1,2,3] SONG Yannan;YIN Wenqiang;LIU Min;LI Qiusha;LIU Qian;HUANG Yanan;XU Xiaofeng;HUANG Dongmei(School of Public Health and Management,Weifang Medical University,Weifang 261053,China;“Health Shandong”Severe Social Risk Prevention and Management Collaborative Innovation Center,Weifang 261053,China;The Innovation Center for Social Risk Governance in Health,Shanghai 200032,China)

机构地区：[1]潍坊医学院公共卫生与管理学院,山东省潍坊市261053 [2]“健康山东”重大社会风险预测与治理协同创新中心,山东省潍坊市261053 [3]国民健康社会风险预警协同创新中心,上海市200032

出　　处：《中国全科医学》2020年第6期649-655,共7页Chinese General Practice

基　　金：国家自然科学基金资助项目（71173158）——我国基本药物制度实施影响评估与政策优化研究（以山东省为例）

摘　　要：背景恶性肿瘤给家庭、社会带来了沉重的医疗、经济负担,极易导致部分家庭"因病致贫"或放弃治疗,目前相关研究多集中于单一病种、分散地域的研究,仍缺乏对于全国范围与多病种恶性肿瘤住院费用变化及结构构成的考量。目的分析2013-2017年我国4种恶性肿瘤住院费用水平以及影响住院费用的主要项目和结构变动情况,为控制医疗费用上涨、深化新医改提供参考依据。方法本研究数据来源于《2014中国卫生和计划生育统计年鉴》《2015中国卫生和计划生育统计年鉴》《2016中国卫生和计划生育统计年鉴》《2017中国卫生和计划生育统计年鉴》以及《2018中国卫生健康统计年鉴》,样本跨度为2013-2017年。统计"30种疾病人均住院费用"中的胃恶性肿瘤、肺恶性肿瘤、食管恶性肿瘤以及膀胱恶性肿瘤的数据,4种恶性肿瘤的人均住院费用包括药费、检查费、治疗费、手术费和手术材料费。2019年4-8月,采用结构变动度法分析我国2013-2017年4种恶性肿瘤的住院费用的结构变动情况〔结构变动值(VSV)、结构变动度(DSV)、结构变动贡献率〕。结果 2013-2017年,4种恶性肿瘤的人均住院费用逐年上升,其中胃恶性肿瘤的人均住院费用始终最高,且肺恶性肿瘤的人均住院费用上升幅度最大。2013-2017年,在4种恶性肿瘤住院各项费用的占比中,药费占比最高且总体逐年下降。从4种恶性肿瘤住院各项费用的实际变化来看,药费在2013-2014年有所上升,2014-2017年逐年下降;检查费在2013-2014年下降,2014-2017年缓慢上升;手术费与手术材料费在2013-2017年逐年上升。2013-2017年,在4种恶性肿瘤住院各项费用中均是药费的VSV最大;4种恶性肿瘤药费、检查费的VSV均呈负向变化,手术费和手术材料费的VSV均呈正向变化,治疗费的VSV增减均不明显。2013-2017年,4种恶性肿瘤住院费用的DSV从大到小依次为肺恶性肿瘤、�Background Malignant tumors have brought a heavy medical and economic burden to the family and society,which is easy to cause some families falling into poverty due to illness or giving up treatment.Current studies about tumors mostly focus on single tumor or a region.And hospitalization costs and their structural variation of multiple tumors have been rarely studied at the national level.Objective To analyze the hospitalization costs of four kinds of malignant tumors in China from 2013 to 2017,as well as the main items and structural changes that affect the hospitalization expenses,so as to provide a reference for controlling the increase of medical expenses and deepening the medical reform.Methods The data were collected from China’s Health and Family Planning Statistical Yearbook(2014-2017)and China Health Statistics Yearbook 2018,involving samples collected from 2013 to 2017.The data of gastric,lung,esophageal and bladder malignant tumors in "30 kinds of diseases per capita hospitalization medical expenses" were counted,in which per capita hospitalization cost includes drug cost,examination fee,treatment cost,operation cost and surgical material cost.Structural variation analysis was performed during April to August 2019 to analyze the structural variation〔value of structural variation(VSV),degree of structural variation(DSV),and contribution rate of DSV to structural variation〕of hospitalization costs of these 4 tumors.Results From 2013 to 2017,the per capita hospitalization cost for 4 tumors increased year by year,among which the per capita hospitalization cost of gastric malignant tumors was always the highest,and that of lung malignant tumors increased the most.During this period,drug cost accounted for the greatest percentage of the hospitalization cost for these 4 tumors,but decreased year by year in general.Specifically,analyzing the changes of the 5 components of hospitalization cost showed that drug cost increased between 2013 and 2014,but decreased between 2014 and 2017 year by year.After the

关 键 词：恶性肿瘤 住院费用 结构变动度 结构变动贡献率 胃癌 肺癌 食管癌 膀胱癌 

分 类 号：R197[医药卫生—卫生事业管理]