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预防医学  2022, Vol. 34 Issue (7): 672-675    DOI: 10.19485/j.cnki.issn2096-5087.2022.07.005
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DRGs实施前后温岭市肺癌患者就诊费用及个人负担比较
赵紫暄1, 王乐2, 王悠清2, 杨易1, 董恒进1,3, 杜灵彬2
1.浙江大学医学院公共卫生学院,浙江 杭州 310058;
2.中国科学院大学附属肿瘤医院(浙江省肿瘤医院),浙江 杭州 310022;
3.浙江大学医学院附属第四医院,浙江 义乌 322000
Comparison of healthcare expenditures and self-payment among patients with lung cancer in Wenling City before and after implementation of diagnosis-related groups (DRGs)
ZHAO Zixuan1, WANG Le2, WANG Youqing2, YANG Yi1, DONG Hengjin1,3, DU Lingbin2
1. School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China;
2. Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, Zhejiang 310022, China;
3. The Fourth Hospital Affiliated to Zhejiang University School of Medicine, Yiwu, Zhejiang 322000, China
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摘要 目的 比较按病种付费(DRGs)实施前后温岭市肺癌患者就诊费用及个人负担的变化,为合理控制医疗费用、减轻患者负担提供依据。方法 通过浙江省温岭市疾病预防控制中心癌症登记数据库和医保局门诊慢特病病种数据库,收集2015—2019年确诊的肺癌参保患者基本信息和就诊费用,比较DRGs实施前(2015—2016年)后(2018—2019年)肺癌患者门诊、住院费用和个人负担的变化情况。结果 纳入肺癌参保患者4 947例,其中男性3 052例,占61.69%;女性1 895例,占38.31%;年龄为(64.88±11.64)岁。2015—2016年年人均就诊费用为56 675.85元,其中门诊费用占14.48%,住院费用占85.52%;2018—2019年年人均就诊费用为38 702.94元,较2015—2016年减少31.71%,其中门诊费用占24.49%,住院费用占75.51%。2018—2019年门诊、住院和总体个人负担率分别为25.38%、32.49%和29.67%,低于2015—2016年的50.84%、50.96%和50.95%,差异均有统计学意义(χ2=13.741,P<0.001;χ2=7.015,P=0.008;χ2=9.340,P=0.002)。结论 DRGs实施后,肺癌参保患者年人均就诊费用和个人负担率降低。
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赵紫暄
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董恒进
杜灵彬
关键词 按病种付费肺癌门诊费用住院费用个人负担    
AbstractObjective To investigate the healthcare expenditures and self-payment among patients with lung cancer in Wenling City before and after implementation of diagnosis-related groups (DRGs), so as to provide the evidence for controlling medical costs and relieving burdens of patients with lung cancer. Methods The basic data and healthcare expenditures of lung cancer patients that were definitively diagnosed from 2015 to 2019 and covered by medical insurance were captured from the cancer registration database of Wenling Center for Disease Control and Prevention and the database of chronic and specific diseases in Wenling Bureau of Medical Insurance. The changes of outpatient expenditures, inpatient expenditures and self-payments were compared before (2015-2016) and after implementation of DRGs (2018-2019) among lung cancer patients. Results Totally 4 947 lung cancer patients covered by medical insurance were enrolled in this study, including 3 052 males (61.69%) and 1 895 females (38.31%), with a mean age of (64.88±11.64) years. The annual mean healthcare expenditure was 56 675.85 Yuan per capita during the period between 2015 and 2016, in which 14.48% were outpatient expenditures and 85.52% were inpatient expenditures, and the annual mean healthcare expenditure was 38 702.94 Yuan per capita during the period between 2018 and 2019 (a 31.71% reduction as compared to that in 2015 and 2016), in which 24.49% were outpatient expenditures and 75.51% were inpatient expenditures. The proportions of outpatient expenditures, inpatient expenditures and total self-payments consisted of 25.38%, 32.49% and 29.67% of total healthcare expenditures in 2018 and 2019, which were significantly lower than those (50.84%, 50.96% and 50.95%, respectively) in 2015 and 2016 (χ2=13.741, P<0.001; χ2=7.015, P=0.008; χ2=9.340, P=0.002). Conclusions The annual mean healthcare expenditures per capita and the proportion of self-payment reduce among lung cancer patients covered by medical insurance following implementation of DRGs.
Key wordsdiagnosis related groups    lung cancer    outpatient expenditure    hospitalization expenditure    self-payment
收稿日期: 2022-02-08      修回日期: 2022-05-02      出版日期: 2022-07-10
中图分类号:  R734.2  
通信作者: 杜灵彬,E-mail:dulb@zjcc.org.cn   
作者简介: 赵紫暄,博士研究生在读,主要从事卫生经济、卫生政策评估工作
引用本文:   
赵紫暄, 王乐, 王悠清, 杨易, 董恒进, 杜灵彬. DRGs实施前后温岭市肺癌患者就诊费用及个人负担比较[J]. 预防医学, 2022, 34(7): 672-675.
ZHAO Zixuan, WANG Le, WANG Youqing, YANG Yi, DONG Hengjin, DU Lingbin. Comparison of healthcare expenditures and self-payment among patients with lung cancer in Wenling City before and after implementation of diagnosis-related groups (DRGs). Preventive Medicine, 2022, 34(7): 672-675.
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