新疆某三甲医院肺癌患者疾病经济负担影响因素及趋势分析

发布时间：2018-02-19 18:50

  本文关键词： 肺癌 直接疾病经济负担 间接疾病经济负担 趋势分析　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:了解新疆某三甲医院肺癌患者直接疾病经济负担和间接疾病经济负担状况,影响因素及发展趋势,一方面提高人们对肺癌疾病的重视,加强疾病预防,另一方面为卫生决策提供依据。方法:(1)对200名问卷调查患者的直接疾病经济负担进行描述性统计分析,其中对直接医疗负担影响因素进行单因素线性回归分析,对直接疾病经济负担影响因素进行多重线性回归分析;利用人力资本法和DALY相结合的方法计算间接疾病经济负担。(2)对6640名肺癌患者直接医疗负担使用T检验或者秩和检验进行差异性分析;通过时间序列模型和灰色模型对未来肺癌疾病经济总负担发展趋势进行预测。结果:(1)肺癌患者主要以老年男性人群为主(2)直接疾病经济负担:200名肺癌患者直接人均经济负担大概在66989.74-89318.99元之间,经过多重线性回归分析住院天数对直接经济负担的影响最明显(P0.05)。直接疾病经济负担包括直接医疗负担和直接非医疗负担,直接医疗负担以药费和诊断费为主,药费中以西药费为主,西药费出现下降趋势,而中药费有所上升。不同民族和手术与非手术患者,不同年龄肺癌患者与不同出院转归类型肺癌患者之间医疗负担差异均有统计学意义(P≤0.05)。中年人群人均直接医疗负担最重,为59441.58元,老年人群次之,人均直接医疗负担为51589.69元,农民人均直接医疗负担最重,达63611.02元,城镇居民人群次之,达57698.10元,同时住院天数越长,人均直接医疗负担越重,经线性回归方程分析性别、年龄、职业、医保、住院天数均对直接医疗负担有显著影响(p0.05);直接非医疗负担中照料着花费所占比重最大,交通费用呈现逐年增长趋势,每年非直接医疗负担均在一万元以上。(3)间接疾病经济负担:15岁—44岁的肺癌患者间接疾病经济负担最重,人均间接疾病经济负担达324246元,且住院天数越长,间接疾病经济负担越重。(4)趋势:通过时间序列和灰色模型发现肺癌患者的医疗总负担均呈缓慢上升趋势。结论:新疆肺癌患者疾病经济负担较重且有日趋上升趋势,要缓解肺癌疾病对人民生活得影响还必须要规范肺癌疾病治疗方案,强化医院管理制度,合理控制住院天数,还要加快医疗保险制度改革,促进公平性,完善医疗救助制度,真正做到“精准扶贫”,尽可能降低肺癌患者疾病经济负担,同时还需要将人口老龄化与肺癌疾病经济负担的缓解相结合,加强肺癌的长期监测,探索发病机制,从根本上降低肺癌患者疾病经济负担。
[Abstract]:Objective: to understand the direct and indirect economic burden of lung cancer patients in a third class hospital in Xinjiang, the influencing factors and the developing trend, on the one hand, to increase the attention of people to lung cancer diseases, and to strengthen the prevention of lung cancer. On the other hand, to provide the basis for health decision making. Methods: the direct economic burden of disease was analyzed by descriptive statistical analysis in 200 patients with questionnaire, among which single factor linear regression analysis was used to analyze the influencing factors of direct medical burden. Multiple linear regression analysis was carried out on the factors affecting the economic burden of direct diseases. Using the combination of human capital method and DALY to calculate the indirect economic burden of disease.) to analyze the difference of the direct medical burden of 6640 patients with lung cancer by T test or rank sum test. The economic burden of lung cancer in the future was predicted by time series model and grey model. Results: 1) the patients with lung cancer were mainly elderly men (2) the direct economic burden of lung cancer was 200 patients with lung cancer. The average economic burden is about 66989.74-89318.99 yuan, After multiple linear regression analysis, the effect of hospitalization days on the direct economic burden was most obvious (P 0.05). The direct economic burden of disease included direct medical burden and direct non-medical burden, and the direct medical burden mainly consisted of medical expenses and diagnostic fees. The cost of western medicine is mainly in the west, and the cost of western medicine is decreasing, while the cost of traditional Chinese medicine has increased. There were significant differences in medical burden between lung cancer patients of different ages and patients with different types of discharged lung cancer (P 鈮，

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