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目的探讨子宫颈癌患者的住院费用及其影响因素,为控制医疗费用的不合理增长,完善医疗保健制度和子宫颈癌防治策略提供依据。方法收集山西省某三级甲等综合医院2002~2011年间子宫颈癌患者的总费用及构成,并分析影响子宫颈癌患者住院费用的因素。结果共收集病例949名,年龄在22~75岁之间,平均年龄为48.9±8.7岁,70%以上的患者为农民。66%的患者为自费医疗,子宫颈癌患者平均住院天数(中位数)12 d,人均住院费用为7992.2±2718.8元,10年间住院费用呈不断增长趋势,平均年增率为6.7%。子宫颈癌住院费用的影响因素为:年龄(P=0.015)、职业(P﹤0.001)、入院情况(P=0.002)、病理诊断(P﹤0.001)、有无合并症(P﹤0.001)、住院天数(P﹤0.001)、药品比例(P﹤0.001)、治疗效果(P﹤0.001)、支付方式(P﹤0.001)。结论我国子宫颈癌治疗费用仍处于较高水平,在保证医疗质量的前提下,加强药品管理和缩短住院日是降低子宫颈癌住院费用有效可行的手段。
Objective To investigate the hospitalization costs of cervical cancer patients and its influencing factors, and to provide evidences for controlling the unreasonable increase of medical expenses, improving the medical care system and preventing and controlling cervical cancer. Methods The total cost and constitution of cervical cancer patients in a tertiary general hospital from 2002 to 2011 in Shanxi Province were collected and analyzed for the factors influencing hospitalization costs in patients with cervical cancer. Results A total of 949 cases were collected, ranging in age from 22 to 75 years. The mean age was 48.9 ± 8.7 years. More than 70% of the patients were farmers. Sixty-six percent of patients were paid for medical treatment at their own expense. The average number of days of hospitalization for cervical cancer was 12 days (median), and the per capita hospitalization cost was 7992.2 ± 2718.8 yuan. The cost of hospitalization ten years increased at an average annual rate of 6.7%. The influencing factors of hospitalization cost were age (P = 0.015), occupation (P <0.001), admission (P = 0.002), pathological diagnosis (P <0.001) Hospitalization days (P <0.001), drug ratio (P <0.001), treatment effect (P <0.001) and payment method (P <0.001). Conclusion The cost of cervical cancer treatment in our country is still at a high level. Under the premise of ensuring the quality of medical treatment, strengthening drug management and shortening the hospitalization days are effective and feasible measures to reduce the hospitalization cost of cervical cancer.