城镇基本医疗肝癌患者住院费用结构及影响因素分析

Analysis of hospitalization expenses structure and influencing factors of liver cancer patients withurban basic medical insurance

目的通过分析原发性肝癌患者住院费用的影响因素进行,为减轻患者医疗经济负担提供依据。方法从住院日期为2016年1月～2017年6月南宁市城镇职工医疗保险数据库中抽取诊断为原发性肝癌的全部出院记录共209例作为研究对象,采用描述性分析、多重线性回归方法对肝癌患者住院费用的结构和影响因素进行分析。结果肝癌患者各项费用在住院总费用中的占比分别为药费40.00%、材料费22.27%、检查费13.78%、化验费11.70%以及治疗费11.10%。住院费用的主要影响因素有是否手术、住院天数、年龄、性别、第几次入院以及是否启动大病保险(P <0.05)。结论住院天数、是否手术、性别、年龄、第几次入院以及是否启动大病保险是住院总费用的影响因素。针对肝癌患者经济负担较重的情况,建议城镇职工基本医疗保险经办机构及医院采取单病种付费,促使医院在利益上节约成本,缩短患者住院时间,减少医疗资源浪费。

Objective To analyze the influencing factors of hospitalization expenses of patients with primary liver cancer, and provide evidence for reducing the medical economic burden of patients. Methods In Nanning medical insurance for urban workers database, 209 discharge records diagnosed as primary liver cancer from January 2016 to June 2017 were collected. The descriptive analysis and multiple linearity regression were used to analyze the structure and influencing factors of hospitalization expenses for patients with liver cancer. Results The proportion of various expenses in the total hospitalization expenses of liver cancer patients were 40.00% of medicine costs, 22.27% of materials costs, 13.78% of inspection fees, 11.70% of laboratory expenses, and 11.10% of treatment expenses. The main influencing factors of hospitalization expenses were whether surgery, hospitalization days, age, gender, number of hospitalizations, and whether using critical illness insurance. Conclusion Hospitalization days, whether surgery, gender, age, number of hospitalizations, and whether or not to use critical illness insurance are factors influencing the total cost of hospitalization. In view of the heavier economic burden of liver cancer patients, it is recommended that the agencies of medical insurance for urban employees and hospitals adopt a single-disease fee-system to encourage hospitals to save costs in terms of benefits, shorter the number of hospital stays, and reduce the waste of medical resources.