重庆市急性早幼粒细胞白血病患儿住院治疗直接经济负担的调查

Investigation of the Direct Economic Burden of Hospitalization for Children with Acute Promyelocytic Leukemia in Chongqing

目的:分析重庆市急性早幼粒细胞白血病(Acute Promyelocytic Leukemia,APL)患儿住院治疗的经济负担情况,探究住院费用的影响因素,为医保政策的制定提供依据。方法:选取2016—2020年重庆市某三级甲等儿童医院住院治疗完成治疗方案的APL患儿为调查对象,收集其住院时间、费用、医保报销情况等信息。结果:所有APL患儿治疗费用均值为174620.44元。低危组患儿人均治疗总费用为127008.69元,高危组患儿人均治疗总费用为207196.91元。低危组重庆市医保患儿中治疗人均总费用为124027.44元,住院自费比例为25.24%,高危组重庆市医保患儿人均总费用为215338.45元,住院自费比例为33.02%。在总住院费用中,药品费(29.22%)占比最高。住院总天数越长,住院总费用越高,差异有统计学意义(t=18.129,P<0.01)。危险程度中,高危组治疗费用高于低危组,差异有统计学意义(t=-5.378,P<0.01)。结论:应通过完善医疗保障制度,控制药品费及住院时长等,降低疾病给家庭造成的经济负担。

Objective:To analyze the economic burden of hospitalization for children with Acute Promyelocytic Leukemia(APL)in Chongqing,and to investigate the factors influencing hospitalization costs,so as to provide a basis for the formulation of medical insurance policies.Methods:Children with APL who were hospitalized in the hospital from 2016 to 2020 to complete the treatment program were used as the survey population and information on their length of stay,cost,and health insurance reimburse⁃ment was collected.Results:The mean cost of treatment for all children with APL was 174620.44 yuan.The total per capita treat⁃ment cost for children in the low-risk group was 127008.69 yuan,and the total per capita treatment cost for children in the high-risk group was 207196.91 yuan.The total per capita cost of treatment among children with Chongqing medical insurance in the low-risk group was 124027.44 yuan,and the out-of-pocket hospitalization rate was 25.24%,while the total per capita cost of children with Chongqing medical insurance in the high-risk group was 215338.45 yuan,and the out-of-pocket hospitalization rate was 33.02%.The cost of drugs(29.22%)accounted for the highest proportion of the total hospitalization cost.The longer the total days of hospitalization,the higher the total hospitalization cost,with a statistically significant difference(t=18.129,P<0.01).The cost of treatment was higher in the high-risk group than in the low-risk group,with a statistically significant difference(t=-5.378,P<0.01).Conclusion:The financial burden of the disease on families should be reduced by improving the medical insurance sys⁃tem and controlling the cost of drugs and the length of hospitalization.