中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2009年
4期
258-261
,共4页
肺疾病%慢性阻塞性%肺肿瘤%费用%医疗%死亡
肺疾病%慢性阻塞性%肺腫瘤%費用%醫療%死亡
폐질병%만성조새성%폐종류%비용%의료%사망
Pulmonary disease,chronic obstructive%Lung neoplasms%Fees,Medical%Death
目的 对因COPD急性加重(AECOPD)和肺癌入院并死亡病例的住院期间医疗费用进行调在,了解两种疾病终未期住院费用的状况.方法 采用回顾性研究方法 调查北京协和医院2003年至2007年因AECOPD或肺癌住院并死亡病例的住院费用.两组间总费用及不同费用间比较采用Wilcoxon秩和枪验,对不同费用所占比例采用独立样本t检验.结果 共416例入组,其中肺癌330例,AECOPD 86例.AECOPD病例并发肺部感染、呼吸衰竭和肺心病以及冠心病、高血压和脑血管疾病的比例明显高于肺癌病例,211例(63.94%)肺癌病例出现重要脏器转移.AECOPD和肺癌病例住院费用总构成无明显差别,其中药费所占比例最高,分别为(37.2±12.6)%和(53.8±17.6)%,其次为治疗费[分别为(30.7±13.8)%和(17.9±11.5)%]及辅助检查费用[分别为(20.8±11.4)%和(16.5±8.6)%].AECOPD病例人均总费用的中位数(四分位间距)为74 143(102608)元,明显高于肺癌病例的37810(51 374)元(z=2.48,P＜0.05),其中AECOPD病例的治疗费为19324(61843)元,明显高于肺癌病例的5876(9764元).AECOPD病例药费占总费用比例[(37.2±12.6)%]明显低于肺癌病例[(53.8±17.6)%],治疗费占总费用比例[(30.7±13.8)%]明显高于肺癌病例[(17.9±11.5)%],筹异均有统计学意义(t值分别为7.34和8.00,均P＜0.01).结论 因AECOPD死亡的病例在末次住院期间的医疗费用明显高于肺癌病例,这与生命支持等诊治措施的费用明显增高有关.
目的 對因COPD急性加重(AECOPD)和肺癌入院併死亡病例的住院期間醫療費用進行調在,瞭解兩種疾病終未期住院費用的狀況.方法 採用迴顧性研究方法 調查北京協和醫院2003年至2007年因AECOPD或肺癌住院併死亡病例的住院費用.兩組間總費用及不同費用間比較採用Wilcoxon秩和鎗驗,對不同費用所佔比例採用獨立樣本t檢驗.結果 共416例入組,其中肺癌330例,AECOPD 86例.AECOPD病例併髮肺部感染、呼吸衰竭和肺心病以及冠心病、高血壓和腦血管疾病的比例明顯高于肺癌病例,211例(63.94%)肺癌病例齣現重要髒器轉移.AECOPD和肺癌病例住院費用總構成無明顯差彆,其中藥費所佔比例最高,分彆為(37.2±12.6)%和(53.8±17.6)%,其次為治療費[分彆為(30.7±13.8)%和(17.9±11.5)%]及輔助檢查費用[分彆為(20.8±11.4)%和(16.5±8.6)%].AECOPD病例人均總費用的中位數(四分位間距)為74 143(102608)元,明顯高于肺癌病例的37810(51 374)元(z=2.48,P＜0.05),其中AECOPD病例的治療費為19324(61843)元,明顯高于肺癌病例的5876(9764元).AECOPD病例藥費佔總費用比例[(37.2±12.6)%]明顯低于肺癌病例[(53.8±17.6)%],治療費佔總費用比例[(30.7±13.8)%]明顯高于肺癌病例[(17.9±11.5)%],籌異均有統計學意義(t值分彆為7.34和8.00,均P＜0.01).結論 因AECOPD死亡的病例在末次住院期間的醫療費用明顯高于肺癌病例,這與生命支持等診治措施的費用明顯增高有關.
목적 대인COPD급성가중(AECOPD)화폐암입원병사망병례적주원기간의료비용진행조재,료해량충질병종미기주원비용적상황.방법 채용회고성연구방법 조사북경협화의원2003년지2007년인AECOPD혹폐암주원병사망병례적주원비용.량조간총비용급불동비용간비교채용Wilcoxon질화창험,대불동비용소점비례채용독립양본t검험.결과 공416례입조,기중폐암330례,AECOPD 86례.AECOPD병례병발폐부감염、호흡쇠갈화폐심병이급관심병、고혈압화뇌혈관질병적비례명현고우폐암병례,211례(63.94%)폐암병례출현중요장기전이.AECOPD화폐암병례주원비용총구성무명현차별,기중약비소점비례최고,분별위(37.2±12.6)%화(53.8±17.6)%,기차위치료비[분별위(30.7±13.8)%화(17.9±11.5)%]급보조검사비용[분별위(20.8±11.4)%화(16.5±8.6)%].AECOPD병례인균총비용적중위수(사분위간거)위74 143(102608)원,명현고우폐암병례적37810(51 374)원(z=2.48,P＜0.05),기중AECOPD병례적치료비위19324(61843)원,명현고우폐암병례적5876(9764원).AECOPD병례약비점총비용비례[(37.2±12.6)%]명현저우폐암병례[(53.8±17.6)%],치료비점총비용비례[(30.7±13.8)%]명현고우폐암병례[(17.9±11.5)%],주이균유통계학의의(t치분별위7.34화8.00,균P＜0.01).결론 인AECOPD사망적병례재말차주원기간적의료비용명현고우폐암병례,저여생명지지등진치조시적비용명현증고유관.
Objective To examine the cost for patients who died in hospital with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)compared with those died with lung cancer,and to examine their variations.Methods A retrospective cohort study was performed.The patients who died in hospital between January in 2003 and December in 2007 were enrolled.Statistical analysis was performed using the SPSS 13.0.Results Totally 416 patients were enrolled,with 86 COPD patients and 330 lung cancer patients.Patients with COPD were older than those with lung cancer.The incidences of comorbidities such as coronary artery disease,hypertension,cerebrovascular disease,respiratory failure and lung infection in AECOPI)patients were higher than those in lung cancer patients.Second malignant neoplasm of important organs was found in 211 patients(63.94%)with lung cancer.In the last hospitalization,the total amount of direct medical costs was higher for patients with AECOPD than for patients with lung cancer[74143(102608)RMB vs 37 810(51374)RMB],z=2.48,P＜0.05,especially for the treatment cost[(19324(61843)vs 5876(9764),z=4.55,P＜0.01]and the laboratory cost[7976(18 397)vs 3397(4096),z=5.97,P＜0.01].There was no significant difference in the constituents of the cost between COPD and lung cancer patients(X2=8.23,P＞0.05).The percentage of the drug cost to the total cost was the highest,followed by the treatment cost and the auxiliary examination cost.The ratio of the drug cost to the total cost was lower in COPD patients(37.2±12.6)% vs(53.8±17.6)%,t=7.34,P＜0.01.while the constituent ratio of treatment cost was higher in COPD than in lung cancer patients (30.7±13.8)%,(17.9±11.5)%,t=8.00,P＜0.01.Conclusions There was significant variability in healtheare resource utilization between COPD and lung cancer patients in their last hospitalization of life,the main reason of which was the increased costa of maintenance of life.
