基于社会生态理论的跨省异地就医肿瘤患者住院费用影响因素研究  

Study on influencing factors of hospitalization expenses of cross⁃province cancer patients based on social⁃ecological theory

作　　者：宋天煜 马荣菲 李紫航 汤质如[1] SONG Tianyu;MA Rongfei;LI Zihang;TANG Zhiru(School of Health Service and Management,Anhui Medical University,Hefei 230032,China)

机构地区：[1]安徽医科大学卫生管理学院,安徽合肥230032

出　　处：《南京医科大学学报（社会科学版）》2024年第2期189-194,共6页Journal of Nanjing Medical University（Social Sciences）

基　　金：安徽省异地就医管理中心横向合作项目“我省跨省异地就医现状及对医保基金影响研究”(k2021119)。

摘　　要：文章基于社会生态理论框架,采用描述性统计和混合线性模型探讨影响跨省异地就医肿瘤患者住院费用的社会生态因素。结果表明,跨省异地就医消化器官恶性肿瘤患者占比最高(18.66%),动态未定或动态未知的肿瘤次均住院费用最高(45535.24元);住院费用受个人特征中的肿瘤类型、个人行为中的住院天数、环境层次中的就医距离、政策层次中的实际报销比例的影响(P<0.05)。需从跨省异地就医肿瘤患者个体及其所处生态环境层面分析住院费用的影响因素,以合理配置卫生资源、引导患者有序就医。This paper uses descriptive statistics and a mixed linear model to explore the social⁃ecological factors affecting the hospitalization expenses of cross⁃provincial cancer patients to understand the influencing factors of their hospitalization expenses based on the framework of social ecology theory.The results showed that patients with malignant tumors of digestive organs in cross⁃province medical treatment were the highest among sampled population(18.66%),with the highest average hospitalization cost of tumors found in patients with uncertain or unknown dynamics(45535.24 yuan).The hospitalization expenses were influenced by tumor types,personal behaviors like the length of hospitalization days in personal behavior,the distance of medical treatment at the environmental level,and the actual reimbursement ratio at the policy level(P<0.05).The hospitalization cost of cancer patients in different provinces was relatively high,which was affected by many social and ecological factors.It is necessary to analyze the influencing factors of hospitalization expenses from both the individual perspective of cross⁃province cancer patients and the ecological environment in which they live,to rationally allocate health resources and guide patients to seek medical treatment in order.

关 键 词：跨省异地就医 社会生态理论 住院费用 影响因素 混合线性模型 

分 类 号：R197.1[医药卫生—卫生事业管理]