山东省肺癌住院患者直接经济负担影响因素分析

摘要

目的：分析肺癌病人的住院费用情况，对病人的直接经济负担进行估算，为加强医院医疗费用管理、医疗保险部门的医疗服务管理，制定费用控制措施，合理利用当前有限的医疗经费和卫生资源提供参考依据。方法采用调查问卷和访谈形式获得基础数据，运用SPSS 16.0统计分析软件进行研究指标的描述性统计分析、单因素分析和多元逐步回归多因素分析。结果肺癌患者直接经济负担补偿前、补偿后分别为59449元、34023元，是山东省2014年城镇居民人均可支配收入的2.03倍、1.16倍；住院费用约占肺癌患者直接经济负担的85%，控制住院费用是减轻直接经济负担的关键；医疗保险实际报销比例较低，通过补偿肺癌患者直接经济负担有所减轻，但仍达50%以上；“重治轻防”局面有待进一步改观。结论提高医疗保险补偿比例，完善医疗保险补偿方案；加强医院管理，规范诊治，减少住院天数，降低病人住院费用；加强宣传教育、早诊早治，实现防治关口前移，加强恶性肿瘤的防治工作。%Objective On the analysis of the lung cancer patient's hospitalization costs, by the estimation of the direct economic burden of patients, to provide references for strengthening the management of hospital medical costs and the medical service management of medical insurance department, formulating cost control measures, and utilizing rationally the limited medi-cal funds and health resources. Methods By questionnaires and interviews we obtained basic data, and by using SPSS 16. 0 sta-tistical analysis software we conducted the descriptive statistical analysis, single factor analysis and multivariate analysis of the re-search indicators. Results The direct economic burden of patients with lung cancer before and after compensation was 59 449 yuan and 34 023 yuan respectively, 2. 03 times and 1. 16 times of per capita disposable income of urban residents in Shandong Province in 2014. Hospitalization expenses accounted for about 85% of the direct economic burden of lung cancer patients, so controlling the hospitalization cost was critical to releasing the direct economic burden. The actual reimbursement ratio of the medical insurance was low, and though the direct economic burden of lung cancer patients was reduced through compensation, it amounted to more than 50%. further The situation needed to be improved. Conclusion We should increase the proportion of medical insurance compensation, improve medical insurance compensation scheme, strengthen hospital management, normative diagnosis and treatment, reduce the length of hospital stay, reduce the inpatient expenses, strengthen publicity and education for early diagnosis and early treatment, prevent diseases earlier, and strengthen the prevention and treatment of malignant tumor.