恶性肿瘤病人住院费用分析——基于上海市城镇职工医保的实践

Analysis of Hospitalization Expenses of Malignant Tumors in Patients with Medical Insurance

目的:探讨恶性肿瘤患者住院费用的构成。方法:收集长宁区8家二级综合性医疗机构2012年医保住院肿瘤病人的住院费用,分析患者年龄、医保支付、个人支付费用构成。结果:医保恶性肿瘤病人的住院费用个人支付比例虽然随着年龄的增大,其支出比例逐渐减少,但总的支出比例接近40%,肿瘤病人的个人费用偏高。结论:通过调整医保政策、合理使用医保支付等手段,可有效降低恶性肿瘤等重特大疾病患者的医疗负担。

Objectives： To investigate the hospitalization expenses of malignant tumors in patients with medical insurance. Methods：The related data of year 2012 in 8 of the level-2 comprehensive medical institutions in Changning District were collected to analyze the age composition and the distribution of individual payment and insurance payment. Results：Although the amount of individual payment increased with age in these patients, the proportion of their pocket payment gradually reduced, whereas, the proportion of individual payment was still as high as 40%and the total expenditures of tumors are relatively higher than those of other diseases. Conclusion：Through the adjustment of medical insurance policy, and the proper use of medical insurance, it can effectively reduce the medical burden of patients with serious illness.