243例晚期肺肿瘤安宁疗护患者的住院费用特点分析

Analysis of the characteristics of hospitalization expenses of 243 cases of advanced lung tumor with hospice care

目的:通过对晚期肺肿瘤患者的住院费用进行分析,了解静安区临汾路街道社区卫生服务中心安宁疗护病房的住院费用特点。方法:采用回顾性研究方法纵向分析2012年1月—2017年12月临汾路街道社区卫生服务中心安宁疗护病房收治的243例晚期肺肿瘤患者的临床资料及费用情况。结果:2012—2017年间,贴现率调整后的人均住院总费用总体呈下降趋势;贴现率调整后的日均住院费用从2012年的325.2元下降到2017年的284.2元。镇痛镇静药费结构比在2016至2017年间呈上升趋势;其他药费结构比则从2012年的19.8%下降至2017年的11.7%;检查检验费总体呈下降趋势;诊疗治疗费结构比增幅不大;护理费的结构比总体呈上升趋势;其他费用结构比呈现略有上升的趋势。结论:安宁疗护服务能够有效降低晚期肺肿瘤患者临终阶段的医疗费用,减轻患者的经济负担。应加强对安宁疗护专业机构、肿瘤专科医院及综合性医院医务人员安宁疗护知识及理念的相关培训,有效促进安宁疗护机构与二、三级医院间的转介机制,带动并提升社会对安宁疗护的知晓与接受度,使其在我国基本医疗服务体系中体现应有的价值。

Objective: Through the analysis of hospitalization expenses of patients with advanced lung cancer to understand the characteristics of hospitalization expenses in the Hospice Ward of Linfen Community Health Service Center of Jingan District. Methods: A retrospective study was conducted to longitudinally analyze the clinical data and costs of 243 patients with advanced lung tumors admitted to the Hospice Ward of Linfen Community Health Service Center from January 2012 to December 2017. Results: Between 2012 and 2017, the total per capita hospitalization expenses after the discount rate adjustment showed a general downward trend;the average daily hospitalization expenses after the discount rate adjustment decreased from 325.2 Yuan in 2012 to 284.2 Yuan in 2017. The structure ratio of analgesic sedative fees was on an increase from 2016 to 2017;the ratio of other drug fees decreased from 19.8% in 2012 to 11.7% in 2017;the inspection fees generally showed a downward trend;the structure of medical treatment fees had not increased much;the structure ratio of nursing fees was generally higher than the overall trend;other fees generally showed a slight upward trend. Conclusion: The hospice care service can effectively reduce the medical expenses of patients with advanced lung cancer in the terminal stage and reduce their economic burden. Relevant training on hospice care knowledge and concepts of hospice care professional institutions, oncology-hospitals and general hospital medical staff should be strengthened to effectively promote the referral mechanism between hospice care institutions and secondary and tertiary hospitals, and promote and enhance the society’s awareness and acceptance of hospice care so as to make it worthy of its value in China’s basic medical service system.