广西某肿瘤医院原发性肺癌患者临床特征和医疗服务等趋势分析

Trend analysis of clinical features and medical services of primary lung cancer patients in a cancer hospital in Guangxi

  • 摘要: 目的:了解广西肺癌的社会人口学特征、临床病理特征、医疗服务利用等情况,为广西肺癌的筛查诊治提供理论依据。方法:采用回顾性调查研究,对广西某肿瘤医院2005—2014年收治的原发性肺癌患者的社会人口学特征、临床特征、医疗服务利用、医疗费用等数据进行描述性分析以及趋势χ2检验,分析10 年变化趋势。结果:共纳入1 000 例肺癌患者,平均确诊年龄为(69.73±11.05)岁,男女比例为2.38∶1,肺癌性别比例差距逐渐缩小。45~59 岁患者比例从2005 年的13.00%上升到2014 年的35.00%,≥60 岁患者的比例从86.00%下降到61.00%(P<0.05)。参加城镇居民、职工医疗保险以及新型农村合作医疗的肺癌患者逐年增长,自费患者比例逐年下降(P<0.05)。2005—2014年,胸部CT、头部MR、头部CT 和骨扫描的使用总体呈现上升趋势,胸部X 线、颈部超声总体呈现出下降趋势(均P<0.05)。人均诊疗费用、次均诊疗费用和日均住院费用总体呈增长趋势,药品费在住院费用中占比最大,其变化趋势与人均诊疗费用变化趋势一致。结论:2005—2014年广西肺癌男女比例下降,发病年龄趋于年轻化;肺癌的主要检测和诊断方式发生变化,药品费和化验费的升高导致诊疗费用的不断攀升,但主要治疗方式未改变。

     

    Abstract: Objective: To understand the socio-demographic characteristics, clinicopathological characteristics and medical service utilization of lung cancer in Guangxi, and to provide scientific basis for the screening and diagnosis of lung cancer.Methods: A retrospective study was conducted to analyze the data of socio-demographic characteristics, clinical characteristics, medical service utilization, medical expenses and other data of primary lung cancer patients admitted to a cancer hospital in Guangxi from 2005 to 2014, and to analyze the trend in ten years with trend χ2 test.Results: A total of 1000 patients with lung cancer were included.The average age of diagnosis was 69.73±11.05 years old, the ratio of male to female was 2.38:1, and the sex ratio of lung cancer gradually decreased.The proportion of patients aged 45-59 years increased from 13.00%in 2005 to 35.00%in 2014, and the proportion of patients aged ≥60 years decreased from 86.00% to 61.00% (P<0.05).The number of lung cancer patients participating in medical insurance for urban residents and employees as well as New Rural Co-operative Medical System increased, while the proportion of self-funded patients decreased year by year (P<0.05).From 2005 to 2014, the use of chest CT, head MR, head CT and bone scan showed an increasing trend, while the use of chest X-ray and neck ultrasound showed a decreasing trend(all P<0.05).The per cap-ita and per time average diagnosis and treatment cost as well as average daily hospitalization cost showed an increasing trend, the drug cost accounted for the largest proportion of hospitalization cost, and its changing trend was consistent with that of per capita diagnosis and treatment cost.Conclusion: From 2005 to 2014, the male and female proportion of lung cancer in Guangxi decreases, and the age of onset tends to be younger.The main methods of detection and diagnosis of lung cancer have changed, and the increase of drug and laboratory fees has led to the continuous rise of diagnosis and treatment costs, but the main treatment regimens have not changed.

     

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