我国肺癌疾病的直接住院费用负担现状及其问题

Status Quo and Issues of Direct Impatient Cost of Lung Carcinoma in China

目的:了解我国肺癌的直接费用负担现状,提出相应的政策建议。方法:利用《中国卫生统计年鉴》和“北京市卫生统计资料”,以及我国10家三级甲等医院的现场调查数据,估算我国肺癌患者直接医疗费用负担及其增长,分析费用结构和变化情况。结果:我国肺癌住院总费用年均增长速度达16.15%(1996—2005年),肺癌患者日均费用增长速度达12.85%,其中,检查费年均增长率达21.94%,化验费为17.86%,治疗费为16.32%;北京市各年肺癌费用增长趋势与全国情况相近;被调查的10家三甲医院2005年数据结果显示,在肺癌患者的人均住院费用中,药费比例为39.94%,治疗费比例为24.77%,检查费比例为14.06%,化验费比例为4.57%。结论:面对肺癌造成的日益沉重的经济负担,应从降低发病率和控制病种费用两方面入手:首先加大肺癌的预防措施力度,如控烟、改善环境等;其次,完善适合国情的肺癌治疗指南,推动规范化治疗,并且在此基础上建立适当的经济激励机制,保证规范的顺利实施。

Objective To estimate the direct economic burden caused by lung carcinoma in China, and to put forward policy recommendations. Methods With the data from China Statistical Yearbook, Beijing Health Statistical Yearbook and the survey of 10 hospitals at tertiary A level, the increase of total direct cost of the lung carcinoma patients was estimated and the components of the cost and their changes were analyzed. Results The average annual increase of total expenditures on inpatients of lung carcinoma is 16.15%. The average expenditures per inpatient per day increased 12.85%. Among them, examine cost increased 21.94%, assay cost increased 17.86% and therapy cost increased 16.32%. The situation in Beijing is quite similar to that in the whole country. In the 10 hospitals of Beijing, the proportion of medicine cost, therapy cost, examine cost and assay cost were 39.94%, 24.77%, 14.06% and 4.57% respectively. Conclusion Facing the increasingly heavy economic burden of lung carcinoma, to lower the incidence of this disease and to reduce the treatment related cost should be taken into account. Firstly, the prevention of lung carcinoma should be enhanced, such as tobacco control, environment improvement, etc. Secondly, the protocol for the treatment of lung carcinoma should be developed, which should be adapted to the to the Chinese situation. A proper incentive mechanism should be established and implemented for the promoting the implementation of the protocol.