湖北省贫困人口肿瘤和终末期肾病医疗费用及其影响因素分析

Analysis on the medical expenditure and influencing factors of the tumor and end-stage renal diseases of the poor patients in Hubei province

目的分析湖北省贫困人口肿瘤和终末期肾病患者医疗费用基本情况及其影响因素，为大病医保和健康扶贫提出政策性建议。方法选取湖北省武汉市、襄阳市、十堰市3市共545名肿瘤和终末期肾病患者进行问卷调查，抽取其中415名贫困患者的问卷进行数据分析。采用单因素方差、多元线性回归等方法，分析医疗费用的影响因素。结果83．9％的患者认为医疗费用昂贵；患病后家庭年收入明显减少；城市患者在患病前和患病后，家庭年可支配收入均高于农村患者；医保类型和病种类型对医疗费用的影响明显。结论肿瘤和终末期肾病患者中贫困率较高，建议兼顾病种。提高大病保障水平，完善医疗救助制度，以此来减轻贫困人口大病经济负担。

Objective To analyze the basics and influencing factors for the medical expenditure of poor patients of tumor and end-stage renal diseases in Hubei province, and put forward policy recommendations for the critical illness insurance and health poverty alleviation. Methods 535 patients with tumor and end-stage renal diseases in Wuhan, Xiangyan and Shiyan in Hubei province were selected for a questionnaire survey,with 415 of the questionnaires subject to data analysis. Single factor variance analysis and multiple linear regression were used to analyze the influencing factors for their medical expenditure. Results 83.9% of the patients held their medical costs as too high ; 84. 6% of them complaining significant drop of their annual family income due to their diseases; disposable household income of urban patients higher than their rural counterparts both before and after their disease; types of medical insurance and diseases are significant influencing factors for medical expenditure. Conclusions Poverty rate is high among patients of such patients. To reduce their financial burden, the government is recommended to cover more major diseases ,enhance support for those of critical illness and improve the medical assistance system.