多发性骨髓瘤住院患者的直接医疗费用及其影响因素——基于广州医保数据的分析

Analysis of direct medical costs and their influencing factors for in-patients with Multiple Myeloma: Based on the reimbursement claim database in Guangzhou,China

目的:研究多发性骨髓瘤住院患者直接医疗费用及其影响因素。方法:利用2009—2011年广州市城镇职工基本医疗保险(城镇职工医保)和广州市城镇居民基本医疗保险(城镇居民医保)数据库,共收集1 386条住院信息记录。采用对数线性回归模型分析直接医疗费用的影响因素。结果:2009—2011年广州市多发性骨髓瘤住院患者的次均总费用分别为19 319.16、17 364.76和21 427.44元,其中个人现金支付分别为7 049.37、5 216.57和6 475.39元。年龄、医保类型、医院等级和住院天数都是影响直接医疗费用的主要因素。此外,城镇职工医保患者和城镇居民医保患者三年的平均药占比分别为61.92%和69.22%。结论:多发性骨髓瘤直接医疗费用较高,且药费是主要费用来源,同时城镇居民医保患者的经济负担高于城镇职工医保患者。

Objective： To study the direct medical expenses for inpatients with Multiple Myeloma and explore its influencing factors. Methods： A total of 1386 hospitalization records were collected using the reimbursement claim database in Guangzhou City during the period from January 2009 to December 2011, which covered the entire enroll- ees of Urban Employee Basic Medical Insurance （UEBMI） and Urban Resident Basic Medical Insurance （URBMI）. Multivariate logarithmic regression models were used to analyze the influencing factors of direct hospitalization costs. Results： During the period from 2009 to 2011, the total costs of inpatients with Multiple Myeloma were 19319.16, 17364.76 and 21427.44 Yuan, and the individual out-of-pocket cash payments were 7049.37, 5216.5 and 6475.39 Yuan respectively. The major influencing factors on direct medical costs of inpatients with the aforesaid disease were identified to be age, health insurance type, hospital level and length of hospitalization. Besides, the proportion of drug expenses as per average occupancy rate among UEBMI and URBMI cases during three years were 61.92% and 69.22% respectively. Conclusion： The direct medical costs for inpatients with Multiple Myeloma are high and the medicine cost is the main component of total medical expenses. In addition, the economic burden is higher for pa- tients with URBMI than for those with UEBMI for treating Multiple Myeloma.