中国多发性骨髓瘤患者的直接医疗费用分析

Analysis of Direct Medical Expenses f Multiple Myeloma Patients in China

目的分析全国多发性骨髓瘤住院、门诊患者的疾病经济负担和住院费用的影响因素。方法利用2012—2016年全国城镇职工和城镇居民医疗保险数据库,描述性统计分析多发性骨髓瘤患者的费用,并构建多元回归模型,探究影响患者医疗费用的相关因素。结果 2012—2016年我国多发性骨髓瘤住院患者年人均住院时间为39.1 d、36.0 d、36.5 d、31.8 d、34.9 d,年人均住院费用分别为55 204.9元、66 890.9元、88 912.8元、74 086.6元、73 767.4元,其中患者个人自付比例分别为49.1%、59.6%、43.1%、45.9%、46.2%。年人均门诊费用分别为1 262.6元、3 455.5元、6 129.4元、8 008.0元、11 308.1元。住院时间、医保类型、就诊医院等级和性质,以及就诊地区会影响患者的次均住院医疗费用。结论多发性骨髓瘤患者的人均住院费用较高且地区差异较大,疾病经济负担较重,在患者的医疗费用中,药品费用占比最高。

Objective To analyze the influential factors of the economic burden of hospitalization and outpatients for Multiple Myeloma(MM) in the country. Methods National Urban Workers and Urban Residents Medical Insurance Database from 2012 to2016 was used to do descriptive statistical analysis of the costs of patients with MM, and a multiple regression model was constructed to explore related factors that affect patients’ medical costs. Results From 2012 to 2016, the average annual hospital stay of MM patients in the country was 39.1 days, 36.0 days, 36.5 days, 31.8 days, and 34.9 days and the hospitalization expenditure per capita were 55 204.9 RMB,66 890.9 RMB, 88 912.8 RMB, 74 086.6 RMB, 73 767.4 RMB, respectively. And the proportion of out-of-pocket per capita were 49.1%, 59.6%, 43.1%, 45.9%, 46.2%, respectively. The annual outpatient expenses per capita were RMB 1 262.6 yuan, RMB 3 455.5 yuan, RMB 6 129.4 yuan, RMB 8 008.0 yuan, and RMB 11 308.1 yuan. The major influencing factors on medical expenditures were the length of hospitalization, health insurance type, and hospital level. Conclusion Per capita hospitalization costs for MM patients are high and vary by region, and the economic burden of disease is heavy. Among the medical expenses of patients, the cost of medicines accounts for the highest proportion.