本文關(guān)鍵詞： 肺癌 直接疾病經(jīng)濟(jì)負(fù)擔(dān) 間接疾病經(jīng)濟(jì)負(fù)擔(dān) 趨勢(shì)分析　出處：《新疆醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:了解新疆某三甲醫(yī)院肺癌患者直接疾病經(jīng)濟(jì)負(fù)擔(dān)和間接疾病經(jīng)濟(jì)負(fù)擔(dān)狀況,影響因素及發(fā)展趨勢(shì),一方面提高人們對(duì)肺癌疾病的重視,加強(qiáng)疾病預(yù)防,另一方面為衛(wèi)生決策提供依據(jù)。方法:(1)對(duì)200名問卷調(diào)查患者的直接疾病經(jīng)濟(jì)負(fù)擔(dān)進(jìn)行描述性統(tǒng)計(jì)分析,其中對(duì)直接醫(yī)療負(fù)擔(dān)影響因素進(jìn)行單因素線性回歸分析,對(duì)直接疾病經(jīng)濟(jì)負(fù)擔(dān)影響因素進(jìn)行多重線性回歸分析;利用人力資本法和DALY相結(jié)合的方法計(jì)算間接疾病經(jīng)濟(jì)負(fù)擔(dān)。(2)對(duì)6640名肺癌患者直接醫(yī)療負(fù)擔(dān)使用T檢驗(yàn)或者秩和檢驗(yàn)進(jìn)行差異性分析;通過時(shí)間序列模型和灰色模型對(duì)未來肺癌疾病經(jīng)濟(jì)總負(fù)擔(dān)發(fā)展趨勢(shì)進(jìn)行預(yù)測(cè)。結(jié)果:(1)肺癌患者主要以老年男性人群為主(2)直接疾病經(jīng)濟(jì)負(fù)擔(dān):200名肺癌患者直接人均經(jīng)濟(jì)負(fù)擔(dān)大概在66989.74-89318.99元之間,經(jīng)過多重線性回歸分析住院天數(shù)對(duì)直接經(jīng)濟(jì)負(fù)擔(dān)的影響最明顯(P0.05)。直接疾病經(jīng)濟(jì)負(fù)擔(dān)包括直接醫(yī)療負(fù)擔(dān)和直接非醫(yī)療負(fù)擔(dān),直接醫(yī)療負(fù)擔(dān)以藥費(fèi)和診斷費(fèi)為主,藥費(fèi)中以西藥費(fèi)為主,西藥費(fèi)出現(xiàn)下降趨勢(shì),而中藥費(fèi)有所上升。不同民族和手術(shù)與非手術(shù)患者,不同年齡肺癌患者與不同出院轉(zhuǎn)歸類型肺癌患者之間醫(yī)療負(fù)擔(dān)差異均有統(tǒng)計(jì)學(xué)意義(P≤0.05)。中年人群人均直接醫(yī)療負(fù)擔(dān)最重,為59441.58元,老年人群次之,人均直接醫(yī)療負(fù)擔(dān)為51589.69元,農(nóng)民人均直接醫(yī)療負(fù)擔(dān)最重,達(dá)63611.02元,城鎮(zhèn)居民人群次之,達(dá)57698.10元,同時(shí)住院天數(shù)越長,人均直接醫(yī)療負(fù)擔(dān)越重,經(jīng)線性回歸方程分析性別、年齡、職業(yè)、醫(yī)保、住院天數(shù)均對(duì)直接醫(yī)療負(fù)擔(dān)有顯著影響(p0.05);直接非醫(yī)療負(fù)擔(dān)中照料著花費(fèi)所占比重最大,交通費(fèi)用呈現(xiàn)逐年增長趨勢(shì),每年非直接醫(yī)療負(fù)擔(dān)均在一萬元以上。(3)間接疾病經(jīng)濟(jì)負(fù)擔(dān):15歲—44歲的肺癌患者間接疾病經(jīng)濟(jì)負(fù)擔(dān)最重,人均間接疾病經(jīng)濟(jì)負(fù)擔(dān)達(dá)324246元,且住院天數(shù)越長,間接疾病經(jīng)濟(jì)負(fù)擔(dān)越重。(4)趨勢(shì):通過時(shí)間序列和灰色模型發(fā)現(xiàn)肺癌患者的醫(yī)療總負(fù)擔(dān)均呈緩慢上升趨勢(shì)。結(jié)論:新疆肺癌患者疾病經(jīng)濟(jì)負(fù)擔(dān)較重且有日趨上升趨勢(shì),要緩解肺癌疾病對(duì)人民生活得影響還必須要規(guī)范肺癌疾病治療方案,強(qiáng)化醫(yī)院管理制度,合理控制住院天數(shù),還要加快醫(yī)療保險(xiǎn)制度改革,促進(jìn)公平性,完善醫(yī)療救助制度,真正做到“精準(zhǔn)扶貧”,盡可能降低肺癌患者疾病經(jīng)濟(jì)負(fù)擔(dān),同時(shí)還需要將人口老齡化與肺癌疾病經(jīng)濟(jì)負(fù)擔(dān)的緩解相結(jié)合,加強(qiáng)肺癌的長期監(jiān)測(cè),探索發(fā)病機(jī)制,從根本上降低肺癌患者疾病經(jīng)濟(jì)負(fù)擔(dān)。
[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，

本文編號(hào)：1517857