恶性肿瘤病人医疗费用问题研究

A study on medical expenses borne by malignant tumour patients

目的：研究恶性肿瘤病人住院费用的变化规律。方法：采用回顾性调查，利用 ＤＲＧＳ（Ｄｉａｇｎｏｓｉｓ ＲｅｌａｔｅｄＧＲｏｕｐｓ）法、ＳＰＳＳ统计处理软件和自行设计的数据录入软件，进行计算机统计处理。结果：恶性肿瘤病人的平均住院日４３．０８天，平均住院费用７０００．８０元。平均住院费用中，药品费占５６．５７％，检查、治疗费占２２．２２％。在药品费中内科、外科、放疗科的抗肿瘤和免疫药物、抗菌素药物、免疫药物分别占科室药品费的８１．１％、８５．９％和８７．８％。在手术费中，纯手术费占全部手术费用的９．９％，而一次性物品费占全部手术费用的４０．１％。结论：肿瘤病人用药有特殊性，在药效相同的情况下，筛选质优价廉的药物，能用国产药物，不用进口药物，能用普通药物，不用新开发药物。实行恶性肿瘤单病种收费时，需要制定肿瘤疾病诊治规范，接诊治规范标准衡量收费的合理性。技术劳务性收费偏低，一次性物品使用较多，在政策性降低药品费用的同时，提高医疗技术性收费标准。

Objective: To probe the changes in the law governing hospitalization charges borne by patients with malignat tumours. Methods: For a retropective study, the DRGS(Diagnosis Related Groups) method, the SPSS Statistical Software, and the selfdesigned Date - Input Software were adopted to conduct computerized statistical work. Results: The average duration of hospitalization seen in patients with malignant tumours was 43 .08 days. The hospital - stay expenses spent by them averaged 7000 .80 Yuan. of these charges, costs of drugs accounted for 56. 57%; while fees for examinations and therapies made up 22.22%. of the outlay for drugs, the anti - tumour agents plus immune medicaments, the antibiotics and the immune drugs dispensedby the three departments (the internal medicine, the surgery and radiotherapy) accounted for 81. 1 %, 85 .9% and 87. 8% respectively of the departments concerned. of the fees for surgical operation, the money charged or the operation itself made up 9. 9% of the overall charges for surgery; while the charges for dispoSable articles accounted for 40.1 % of the overall collection for the surgical operation. Conclusion: The use of drug therapy for cancer patients has its peculiarity. When several kinds of drugs that can offer identical curative effect, selection of those with better quality but cheaper prices is advisable. Domestic drugs should be prederred to imported ones, and cmmon vcheties to newly devdloped ones. When the charges for the treatment of a single kind of malignant tumor are collected, it is imperative that there be diagnostic and therapeutic guidelines in regard to tumour diseases in outer to judge the reasonability of collection of charges ander stipulations. Currently, the expense for technical service is a bit lower; while the disbursement for the disposable articles tends to be higher. It is suggested that the criteria for charge collection of a teelnical nature be raised, side-by-side with the auductionofdrug charges thrugh favourable policies of the state.