| 刘静敏,王丹丹,卢培培.2018年山东省上消化道癌内镜筛查的直接医疗成本分析[J].中国肿瘤,2020,29(10):763-767. |
| 2018年山东省上消化道癌内镜筛查的直接医疗成本分析 |
| Direct Medical Costs of Upper Gastrointestinal Cancer Endoscopic Screening in Shandong Province in 2018 |
| 中文关键词 修订日期：2020-04-17 |
| DOI：10.11735/j.issn.1004-0242.2020.10.A008 |
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| 中文关键词: 上消化道癌 内镜筛查 直接医疗成本 山东 |
| 英文关键词:upper gastrointestinal cancer endoscopic screening direct medical costs Shandong |
| 基金项目:国家自然科学基金(71904109)；山东省自然科学基金(ZR2019PG006) |
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| 中文摘要: |
| 摘 要：［目的］ 比较山东省不同地区上消化道癌内镜筛查的直接医疗成本，为明确上消化道癌内镜筛查开展的直接医疗成本以及财政补助标准的优化等提供依据。 ［方法］ 依托山东省上消化道癌早诊早治工作平台，根据各地经济发展水平及医院的等级和类型，在山东省东、中、西部各选择1~3家医院，运用微观成本法对2018年开展上消化道癌内镜筛查的直接医疗成本进行分析比较。 ［结果］ 各地上消化道癌内镜筛查的直接医疗成本及其微观构成存在很大差异，且成本与其年总工作量呈负相关；筛查阶段的直接医疗成本，最高为1763.20元/例，最低为200.53元/例，在成本构成方面，以设备和药品成本占比最高；诊断阶段的直接医疗成本，最高为151.99元/例，最低为20.13元/例，在成本构成上，以设备成本占比最高；西部地区医院直接医疗成本高于东、中部地区，三级医院普遍高于二级医院，成本最高的医院年内镜工作量最少，为1915.19元/例、2300例/年，成本最低的医院年内镜工作量最多，为220.66元/例、16 000例/年，在各医院直接医疗成本构成中，均以筛查阶段成本所占比例最高。 ［结论］ 政府应根据各地的实际情况，适当调整财政补助标准，以符合不同地区对上消化道癌内镜筛查财政补助的需要。 |
| 英文摘要: |
| Abstract：［Purpose］ To analyze the direct medical costs of endoscopic screening for upper gastrointestinal cancer in different regions of Shandong Province. ［Methods］ One to three hospitals were selected in eastern，central and western Shandong Province as study sites. The direct medical costs of upper gastrointestinal cancer screening in 2018 were analyzed and compared. ［Results］ The direct medical cost and its microstructure of endoscopic screening for upper gastrointestinal cancer varied greatly in different regions. In screening stage the highest cost was 1763.20 Yuan/case and the lowest was 200.53 Yuan/case，which was negatively correlated with the annual workload. In the diagnostic stage the highest direct medical costs was 151.99 Yuan/case and the lowest was 20.13 Yuan/case，and the cost of equipment accounted for the largest proportion. The direct cost of treatment in the western region was higher than that in the eastern and central regions，and in tertiary hospitals was generally higher than that in secondary hospitals. The hospital with the highest cost(1915.19 Yuan/case) had the lowest annual endoscopy workload(2300cases/year)，and the hospitals with lowest cost(220.66 Yuan/case) had the higher endoscopic workload(16 000 cases/year). The cost in the screening stage accounted for the highest proportion of the total costs. ［Conclusion］ The financial subsidy should be appropriately adjusted according to the actual situation in various regions in the implementation of endoscopic screening of upper gastrointestinal cancer. |
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