【作者】 江涛；

【导师】 王德斌；

【作者基本信息】 安徽医科大学 ， 社会医学与卫生事业管理， 2019， 硕士

【摘要】 目的:以某省新农合系统近五年常见癌症报销数据为基础;1)发现不同地区癌症的分布;2)分析某省不同地区常见癌症患者的卫生服务利用;3)发现不同类型癌症患者住院的天数;4)分析各类癌症患者的住院费用;5)尝试找出在新农合系统中癌症患者报销存在的不合理部分,为降低农村癌症患者经济负担提供有益参考。方法:选取2013-2017年参加某省新型农村合作医疗的肺癌、结直肠癌、食道癌、胃癌、肝癌和乳腺癌六种癌症患者。采用频数、率、算数平均数等描述不同类型肿瘤患者的地区分布情况、各类癌症患者的卫生服务利用、住院天数、住院费用;使用卡方检验、方差分析比较各类癌症患者卫生服务利用、住院天数和住院费用的差异。结果:(1)六类癌症患者共计111220人,胃癌33460人,肺癌26133人,结直肠癌17479人,食道癌14748人,乳腺癌13719人,肝癌5681人;(2)癌症患者累计住院人次285128次,在一级医院住院比例为4.8%,二级医院28.6%,三级医院住院比例为60.8%,其他医院住院比例为5.8%;(3)C9市和C16市的癌症患者在二级医院住院的比例分别为56.2%和52.9%;(4)总体次均住院天数为10.43天,食道癌16.11天、肺癌11.15天、胃癌10.13天、肝癌9.64天、乳腺癌7.45天;(5)平均首次住院天数为14.71天,食道癌21.51天,结直肠癌15.36天、胃癌14.26天、肺癌13.87天、乳腺癌10.94天、肝癌10.58天;(6)非首次住院平均住院天数为7.70天,食道癌10.55天,肺癌9.51天,肝癌9.16天、胃癌7.12天、结直肠癌6.33天、乳腺癌6.11天;(7)次均住院费用为12974.9元,食道癌23314.0元,肝癌16794.0元、结直肠癌12502.7元、胃癌12494.8元、肺癌12445.1元、乳腺癌8074.8元;(8)一级医院2813元、二级医院8327.7元,三级医院15438.1元,其他医院18500.3元;(9)不同地区各癌种的住院费用存在差别。结论:某省农村地区癌症胃癌、肺癌较为常见;癌症患者住院多选择在三级医院;癌症患者住院时间长;癌症患者住院费用高;需要采取措施降低癌症患者的经济负担。更多还原

【Abstract】 Objectives Based on the data of common cancer reimbursement in a Province in the past five years;1)analysis of the distribution of cancer in different regions;2)analysis of the utilization of health services for common cancer patients in different areas of a Province;3)analysis of hospitalization of patients with different types of cancer days;4)analyze the hospitalization expenses of various cancer patients;5)try to find out the unreasonable part of the reimbursement of cancer patients in the new rural cooperative system,and provide a useful reference for reducing the economic burden of rural cancer patients.Methods The whole group was selected from the six cancer patients with lung cancer,colorectal cancer,esophageal cancer,stomach cancer,liver cancer and breast cancer who participated in the new rural cooperative medical care in a Province from 2013 to2017.Frequency,rate,arithmetic mean,etc.were used to describe the regional distribution of different types of cancer patients,the utilization of health services for various cancer patients,the length of hospital stay,and the cost of hospitalization;using chi-square test and analysis of variance to compare the utilization of health services for various cancer patients,Differences between hospital stays and hospitalization expenses.Results(1)A total of 111,220 cancer patients,33,460 gastric cancer,26,133 lung cancer,17479 colorectal cancer,14748 esophageal cancer,13719 breast cancer,and 5,681 liver cancer;(2)285,128 cumulative hospitalizations of cancer patients,The proportion of hospitalization in primary hospitals was 4.8%,that in secondary hospitals was 28.6%, that in tertiary hospitals was 60.8%,and that in other hospitals was 5.8%;(3)cancer patients in C9 and C16 were hospitalized in secondary hospitals.The proportions were56.2% and 52.9%,respectively;(4)the overall average hospitalization days were 10.43 days,esophageal cancer 16.11 days,lung cancer 11.15 days,gastric cancer 10.13 days,liver cancer 9.64 days,breast cancer 7.45 days;(5)average first hospital stay days 14.71 days,21.51 days for esophageal cancer,15.36 days for colorectal cancer,14.26 days for gastric cancer,13.87 days for lung cancer,10.94 days for breast cancer,10.58 days for liver cancer;(6)the average length of hospital stay for non-first hospitalization was 7.70 days,and esophageal cancer was 10.55 days.Lung cancer 9.51 days,liver cancer 9.16 days,gastric cancer 7.12 days,colorectal cancer 6.33 days,breast cancer 6.11 days;(7)the average hospitalization cost is 12974.9 yuan,esophageal cancer 23314.0 yuan,liver cancer 16794.0 yuan,colorectal cancer 12502.7 yuan,gastric cancer 124 94.8 yuan,lung cancer 12445.1 yuan,breast cancer 8074.8 yuan;(8)primary hospital 2813 yuan,secondary hospital 8327.7 yuan,tertiary hospital 15438.1 yuan,other hospitals 18500.3yuan;(9)hospitalization costs of various cancers in different regions exist difference.Conclusion Cancerous gastric cancer and lung cancer are common in rural areas of a Province;cancer patients are mostly hospitalized in tertiary hospitals;cancer patients have long hospital stays;cancer patients have high hospitalization costs;measures need to be taken to reduce the economic burden of cancer patients.更多还原