某地区肺癌住院患者直接经济负担城乡差异比较研究

Study on rural-urban differences of direct economic burdens of lung cancer inpatients in a area

目的探讨城乡肺癌患者的直接经济负担的差异。方法采用自制问卷对某市三级医院肺癌住院患者进行抽样调查。以样本医院的住院患者的城乡别为分组,考察门诊、自购药和住院费用及其中的城乡差异。结果城乡患者人均门诊和住院医疗费用比较差异无统计学意义(P>0.05),但是在自付费用上农村患者均高于城市,且自付比例比较差异有统计学意义(P<0.05)。新农合的保障水平并不能使农村患者免于疾病经济风险,且农村患者就医成本高昂。结论降低就医成本的关键在于引导患者合理利用卫生服务,需要提高新农合保障水平,制订适宜大病诊治的特殊补偿方案。

Objective To investigate the differences of the direct economic burden in the rural-urban inpatients with lung cancer.Methods A sampling survey was carried out among the lung cancer inpatients in tertiary hospitals by using self-designed questionnaires.The inpatients in the sample hospital were divided into two groups according to the census registration of rural and urban area.The differences in the direct economic cost in outpatient services,self-medication purchases and inpatient services between the groups were analyzed.Results There was no statistical difference in the outpatients′and inpatients′medical cost between the two groups.However,the rural patients paid more than the urban patients after getting compensation from the medical insurance.There was statistically significant difference in the proportion of self-pay between the rural and urban patients（P〈0.05）.The New Rural Co-operative Medical System（NRCMS）did not keep the disease economic risk away from the rural patients.Morover they had a high cost in outpatient visit.Conclusion The key for reducing the cost of outpatient visit is to improve the prevention and treatment of lung cancer,we need to strengthen the special examination,guide the rational use of health services,as well as to improve the NRCMS security level by making a suitable compensation scheme for the lung neoplasms.