某市新农合7种恶性肿瘤患者住院费用与保障水平分析

Analyzing the hospitalization expense and insurances from NCMS for patients with 7 kinds of cancers in one City

目的:研究重大疾病保障范围内7种恶性肿瘤患者年均住院费用情况及新农合保障水平,为制定重大疾病补偿政策提供依据。方法:对湖北省某县级市2010年至2012年新农合数据库中7种恶性肿瘤及全病种的次均住院费用、年均住院次数、年均自付费用、可报销比及实际补偿比等指标结果进行描述性分析,对数据分年度、分不同级医疗机构进行比较研究。结果:恶性肿瘤患者市外流向多;患者疾病经济负担重;市级及乡级医疗机构实际补偿比较高,而市外医疗机构就医患者实际补偿比较低。结论:恶性肿瘤疾病的治疗难度使得市外就医趋势增大;恶性肿瘤治疗方式及预后增加了患者经济负担;市外就医使得肿瘤患者实际补偿比较低,疾病经济负担重。

Objective To study the average hospitalization expense and insurances from NCMS for patients with 7 kinds of cancers, and provide references for policymaking. Methods Indexes of average hospitalization expense per time, average hospitaliza tion times per year, average outof pocket expense per year, compensation ratio within the scope of the policy and actual compensa tion ratio of 7 kinds of cancers and all kinds of diseases were obtained from the database of NCMS from 2010 to 2012 and descrip tively analyzed. And data was comparatively studied in years and medical institutions. Results The proportion of cancer patients which chose to hospitalize out of the city was high. Economic burden on cancer patients was heavy. The actual compensation ratio for township and county medical institutions was high, while it was low for extramural medical institutions. Conclusion The difficul ties of treating cancers make more patients preferring to hospitals out of the city. The treatment method and prognosis make cancer patients＇ burden heavier. Hospitalization out of the city decreased the actual compensation ratio and increased economic burden. Author＇s address Hubei Cancer Hospital,Wuhan,P. R. China.