2011-2015年中国肺癌直接经济负担及次均费用分析

Analysis of Direct Economic Burden and Average Hospitalization Cost of Lung Cancer in China in 2011-2015

目的分析2011-2015年全国肺癌患者的直接经济负担及次均费用情况,为肺癌防控及医保政策提供科学依据。方法采用SAS 9.2分别对二级、三级综合医院和肿瘤专科医院的病案首页进行统计,对漏报率较高的医院采用克里格插值法(Kriging),利用住院病案首页的肺癌费用占比推算肺癌住院总费用,利用肿瘤专科医院的门诊住院费用占比推算肺癌医疗费用总体情况。以住院病案首页为基础,分析肺癌患者次均住院费用情况。结果 2015年我国肺癌医疗总费用达243.1亿元,约占卫生总费用的0.6%;2011-2015年肺癌医疗费用持续向三级综合医院集中;60岁以上人群消耗了主要的肺癌医疗费用且占比仍在逐年上升;肺癌次均住院费用在2015年出现下降;2011-2015年各类医院药占比稳步下降;18~40岁年龄组次均住院费用最高。结论医改控费效果逐步显现,将医疗费用增幅控制在可承受范围内;值得注意地是,应加快完善价格补偿机制,同时要有针对性地提高老年人群大病保障水平。

Objective To analyze the direct economic burden and average hospitalization cost of lung cancer in China from 2011 to 2015, to provide data support for the prevention and control of lung cancer and health insurance policies. Methods By using inpatient medical record home page dataset to estimate the total hospital expenses of lung cancer. Using the outpatient hospitalization cost ratio of cancer specialized hospitals to estimate the overall medical expenses of lung cancer. Based on the in- patient medical record home page dataset, and analyzed the average hospitalization cost of lung cancer. Results The total cost of lung cancer in China reached 24. 31 billion yuan in 2015, accounting for about 0. 6% of the total health expenses; from 2011 to 2015 ,lung cancer medical costs have concentrated in the grade 3 general hospitals; people over 60 consumed the major medical costs of lung cancer and the proportion was still rising year by year; the average hospitalization cost of lung cancer was reduced in 2015 ; drug proportion in various hospitals declined steadily from 2011 to 2015 ; the average hospitalization cost was the high- est in the 18 -40 age group. Conclusion The effect of health care reform was gradually revealed,and the increase of medical expenses was controlled within the tolerable range. Notably, we should accelerate the improvement of the price compensation mechanism, and at the same time, we should aim to improve the level of catastrophic health care for the elderly.