不同时期恶性肿瘤患者住院医疗费用及其影响因素对比分析.pdfVIP

不同时期恶性肿瘤患者住院医疗费用及其影响因素对比分析 李枫 高晶蓉 宋桂香 刘丽 【摘要】目的:通过比较分析早、中、晚不同时期恶性肿瘤患者首次住院医疗费用及其影响因素，为有关部门 合理配置卫生资源和制定肿瘤防治策略提供依据。方法:对本市某三家医院2007年十种主要恶性肿瘤患者首次 住院治疗的病案资料进行有关信息和数据的调查，比较分析早、中、晚不同时期患者首次住院医疗费用及其影 响因素。结果:三家医院一共抽取了637份完整住院病历，其中，早期病例占15.5%，中期病例占42.4%，晚期 病例占42.1%；通过健康体检发现的占5.2% ，有不适症状后就诊发现的占85.1% ，自己发现肿块的占9.7%； 在通过健康体检发现的病例中，早期患者的比例(30 .3%)明显高于晚期患者的比例(9.0%)，在通过有不适症 状就诊后发现的病例中，晚期患者的比例(42 .1%)明显高于早期患者的比例(15.4%)；采取手术治疗的早期 (84 .8%)和中期病例(85.6%)明显高于晚期；临床治愈的早期病例(71.7%)和中期病例(54 .1%)明显高于晚期 (17.2%)；早、中、晚三期病例住院期间日均医疗费用分别为1085.90元、1450 .44元和1507.92元，早期肿瘤 患者日均医疗费用明显低于中晚期；如扣除手术费用，早期患者首次住院医疗费用明显低于晚期，且在统计学 上有显著性差异。结论 :早期肿瘤病人住院治疗治愈率比中晚期高；肿瘤病人住院医疗费用与肿瘤类型、治疗 方式、临床分期和合并疾病等有关；肿瘤筛查、健康体检和自我发现对肿瘤的早期发现具有重要意义。 【关键词】恶性肿瘤；早期检查；临床分期；治疗效果；住院费用 【Abstract】Objective :An investigation and analysis for the hospitalization cost of malignant tumors and its influencing factors among different clinical stage was conducted in order to put forward policy recommendations for tumor prevention and intervention in future. Methods:637 inpatient medical records of 10 tumors selected by randomized multistage sampling from 8771 records of three hospitals in Shanghai 2007 was investigated to accept the hospitalization cost and various influencing aspects including clinical stage; finding and treating measure; tumor type; et al. Data analysis was carried out using EPIDATA3.0 and SPSS11.0 statistical package and descriptive statistics of frequency and percentages were used. Results:The percentage of early stage patients was 15.5%, middle stage42.4%, and late stage42.1%. None of them was found by tumor screening, a few(5.2%) was found through physical examination, and most of them(85.1%) were diagnosed after clinical symptoms . The finding percentage of physical examination was 10.1% in early stage patients, 5.6% in middle stage patients, and only 3.0% Surgery was conducted in 84.8% early stage patients, in 85.6%mi