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预防医学  2022, Vol. 34 Issue (4): 350-356    DOI: 10.19485/j.cnki.issn2096-5087.2022.04.006
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宫颈癌与癌前病变患者的经济负担研究
李海涛1, 王岩2, 沈谷群2, 袁敏2, 刘丽萍3, 刘广超1, 朱琳1
1.新疆医科大学公共卫生学院,新疆 乌鲁木齐 830054;
2.新疆医科大学附属肿瘤医院,新疆 乌鲁木齐 830011;
3.托里县人民医院,新疆 托里 834500
Economic burden of patients with cervical cancer and precancerous lesions
LI Haitao1, WANG Yan2, SHEN Guqun2, YUAN Min2, LIU Liping3, LIU Guangchao1, ZHU Lin1
1. School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang 830054, China;
2. Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830011, China;
3. Tuoli County People's Hospital, Tuoli, Xinjiang 834500, China
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摘要 目的 了解宫颈癌与癌前病变的经济负担,为加强宫颈癌防治,制定相关政策降低宫颈癌与癌前病变患者经济负担提供依据。方法 选择2020年9月—2021年6月在新疆地区4家医院治疗的宫颈癌与癌前病变患者为研究对象,采用中国医学科学院肿瘤医院设计的调查表收集直接医疗费用、直接非医疗费用、患者及陪护家属的误工天数等资料,测算宫颈癌与癌前病变患者的经济负担,并采用多重线性回归模型分析宫颈癌患者经济负担的影响因素。结果 纳入265例宫颈癌与癌前病变患者,年龄为(49.80±10.07)岁,其中宫颈癌170例,Ⅰ、Ⅱ和Ⅲ/Ⅳ期分别为64、79和27例;癌前病变95例,低级别(LSIL)和高级别鳞状上皮内病变(HSIL)分别为33例和62例。LSIL、HSIL、Ⅰ、Ⅱ和Ⅲ/Ⅳ期患者的经济负担MQR)分别为11 481(4 523)、17 850(9 096)、112 883(59 623)、150 875(105 206)和197 842(61 844)元/例,其中直接医疗费用占经济负担的85.89%~93.86%。癌前病变患者诊断阶段、临床治疗阶段和随访阶段的经济负担分别为708(1 711)、11 678(6 590)和2 557(19 472)元/例,合计14 943(27 773)元/例;宫颈癌患者分别为910(1 530)、105 770(91 019)和39 765(30 490)元/例,合计146 445(123 039)元/例。多重线性回归分析结果显示,病理分期(β'=0.202,P=0.003)、住院时间(β'=0.695,P<0.001)与宫颈癌患者经济负担相关。结论 宫颈癌与癌前病变患者的经济负担较重。病理分期高、住院时间长可能增加宫颈癌患者的经济负担。
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李海涛
王岩
沈谷群
袁敏
刘丽萍
刘广超
朱琳
关键词 宫颈癌癌前病变经济负担    
AbstractObjective To investigate the economic burden of cervical cancer and precancerous lesions, so as to provide the evidence for improving the management of cervical cancer and formulating the policies for reducing the economic burden of cervical cancer and precancerous lesions. Methods The hospitalized patients with cervical cancer and precancerous lesions were recruited from four hospitals in Xinjiang Uygur Autonomous Region from September 2020 to June 2021. The direct medical expenditures, direct non-medical expenditures, duration of absence from work in patients and their family members as carers were collected using a questionnaire designed by the Cancer Hospital of the Chinese Academy of Medical Sciences, and the economic burdens of cervical cancer and precancerous lesions were estimated. The factors affecting the economic burden of cervical cancer were identified using a multivariable linear regression model. Results Totally 265 patients with cervical cancer and precancerous lesions were included, with an average age of ( 49.80±10.07 ) years. There were 170 patients with cervical cancer, including 64 cases with stage I, 79 cases with stage II, and 27 cases with stages III/Ⅳ, and 95 patients with precancerous lesions, including 33 cases with low-grade squamous intraepithelial lesion ( LSIL ) and 62 cases with high-grade squamous intraepithelial lesion ( HSIL ). The median economic burdens (interquartile range) were 11 481 ( 4 523 ), 17 850 ( 9 096 ), 112 883 ( 59 623 ), 150 875 ( 105 206 ) and 197 842 ( 61 844 ) Yuan per patient among cases with LSIL, HSIL, and stage I, II and III/Ⅳ cervical cancer, respectively, among which the direct medical expenditures accounted for 85.89% to 93.86%. The median economic burdens (interquartile range) were 708 ( 1 711 ), 11 678 (6 590), 2 557 ( 19 472 ), and 14 943 ( 27 773 ) Yuan per patient with precancerous lesions, and were 910 (1 530), 105 770 ( 91 019 ), 39 765 ( 30 490 ), and 146 445 ( 123 039 ) Yuan per patient with cervical cancer during the diagnostic phase, the clinical treatment phase, the follow-up phase, and in total, respectively. Multivariable linear regression analysis results showed that pathological stage ( β'=0.202, P=0.003 ) and duration of hospital stay ( β'=0.695, P<0.001 ) correlated with the economic burden among patients with cervical cancer. Conclusion There is a high economic burden among patients with cervical cancer and precancerous lesions. Advanced pathological stage and long duration of hospital stay may increase the economic burden among cervical cancer patients.
Key wordscervical cancer    precancerous lesion    economic burden
收稿日期: 2021-12-02      修回日期: 2022-01-12      出版日期: 2022-04-10
中图分类号:  R737.33  
基金资助:省部共建中亚高发病成因与防治国家重点实验室开放课题项目(SKL-HIDCA-2020-32); 2021年自治区研究生创新项目(XJ2021G199)
通信作者: 朱琳,E-mail:476674539@qq.com   
作者简介: 李海涛,硕士在读
引用本文:   
李海涛, 王岩, 沈谷群, 袁敏, 刘丽萍, 刘广超, 朱琳. 宫颈癌与癌前病变患者的经济负担研究[J]. 预防医学, 2022, 34(4): 350-356.
LI Haitao, WANG Yan, SHEN Guqun, YUAN Min, LIU Liping, LIU Guangchao, ZHU Lin. Economic burden of patients with cervical cancer and precancerous lesions. Preventive Medicine, 2022, 34(4): 350-356.
链接本文:  
http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2022.04.006      或      http://www.zjyfyxzz.com/CN/Y2022/V34/I4/350
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