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目的分析不同特征肺癌患者的疾病经济负担,探讨其影响因素,为相关政策制定提供科学依据。方法通过哈尔滨市南岗区疾病预防控制中心的肿瘤登记信息系统,找出其下辖的10个社区中在2010—2014年主要诊断为肺癌的存活病例资料,剔除失访病例,对最终纳入的195例患者进行回顾性问卷调查,应用SPSS 18.0软件对肺癌的经济负担及其影响因素进行统计描述,单因素方差分析和多重回归分析。结果不同婚姻状况、教育程度、家庭人均收入及医疗保险类型的肺癌患者,其总经济负担的对数值差异有统计学意义(P<0.05);已婚/同居患者的总经济负担为(167 052.63±161 064.79)元,是其他婚姻状况患者[(93 343.90±65 745.69)元]的1.79倍;随着患者受教育程度和家庭人均收入的提高,总经济负担均呈上升趋势;参加城镇职工医疗保险的肺癌患者总经济负担最高,为(181 866.35±165 885.28)元,无医保患者的最低,为(77 698.64±72 372.87)元;多因素分析显示,患者的婚姻状况、家庭人均收入和医疗保险类型是肺癌患者经济负担的主要影响因素。结论应重点关注影响肺癌经济负担的主要因素,提高低收入人群和无医保人群的卫生服务利用可及性,完善社会各种保障制度,切实减轻肺癌患者的经济负担。
Objective To analyze the economic burden of disease in patients with different characteristics of lung cancer and to explore its influencing factors so as to provide a scientific basis for the formulation of relevant policies. Methods Tumor registration information system of Nangang District Center for Disease Control and Prevention in Harbin was used to find out the data of the surviving cases of lung cancer diagnosed in 10 communities under its jurisdiction from 2010 to 2014. The cases of missed cases were excluded. The patients were retrospectively surveyed. The economic burden of lung cancer and its influential factors were statistically described by SPSS 18.0 software, one-way ANOVA and multiple regression analysis. Results There were significant differences in the total economic burden between lung cancer patients with different marital status, educational level, family income per capita and medical insurance (P <0.05). The total financial burden of married / cohabiting patients was (167 052.63 ± 161 064.79) yuan, which was 1.79 times of that of other marital status patients (93 343.90 ± 65 745.69) yuan. With the improvement of education level and per capita income of the family, the total economic burden tended to increase. (181 866.35 ± 165 885.28) yuan for patients with insured lung cancer, and 77 698.64 ± 72 372.87 yuan for patients without insurance. The multivariate analysis showed that the marital status, family income per capita and medical treatment The type of insurance is a major contributor to the economic burden of patients with lung cancer. Conclusion The main factors that affect the economic burden of lung cancer should be focused on, and the availability of health services should be improved for low-income and non-insurance groups, various social security systems should be improved, and the economic burden of patients with lung cancer effectively reduced.