886例乳腺癌病人住院费用影响因素分析

目的分析影响女性乳腺癌患者住院费用的因素,为完善医疗保障制度、合理分配医疗资源和医疗费用分析提供参考依据。方法对山西省某综合医院2004-2011年886例乳腺癌患者住院费用的构成、影响因素等进行分析,采用非条件Logistic回归法分析乳腺癌患者住院费用的影响因素。结果 2004-2011年该院乳腺癌患者住院人数、平均住院费用及日均住院费用总体呈上升趋势;住院费用主要用在药品购买（36.83%）、手术（21.69%）、化验（10.22%）等方面;影响住院费用的主要因素依次为付费方式、住院天数、病理类型、药占比、化验费占比（均有P<0.05）。结论付费方式、住院天数、病理类型、药占比、化验费占比是影响住院费用的主要因素,建议加强对医院药物的科学合理使用、提升医务人员医疗技术和服务水平、缩短住院天数及完善医保制度等措施以有效控制医疗费用增长。     

深圳市早期乳腺癌患者住院费用分析

[目的]分析早期乳腺癌患者住院治疗费用构成与变化。[方法]调查2001～2004年菜市属综合医院住院早期乳腺癌患者病案信息资料。[结果]各年总费用、总药费和总治疗费差异有统计学意义。2003与2004年的手术费用高于2001年和2002年，手术费用的主要构成是药费和检查费。各年放疗、化疗费用差异无统计学意义．但化疗药费相比差异有统寸学意义。[结论]适当降低药品价格和检查费用，扩大医保覆盖面，逐步完善多层次社会健康保障体系，减轻弱势人群大病重病的负担，是当前深圳市卫生工作的重点之一。     

乳腺癌手术病人住院费用及影响因素分析

目的:了解乳腺癌手术病人住院费用情况及主要影响因素,为合理控制医疗费用和医疗保险支付方式改革提出建议.方法:收集2003年1月至2007年8月在江苏省肿瘤医院住院的乳腺癌手术病例共495例,采用描述性分析、Kruskal-Wallis H检验和多元线性逐步回归方法进行分析.结果:乳腺癌手术病人的平均住院费用为17 864.62元,影响费用的主要因素是住院天数、药费比例、费用负担形式和是否实施规范化诊疗.结论:合理缩短住院天数、减少药品费用、推广规范化诊疗和加快医疗保险支付方式改革是控制乳腺癌手术病人住院费用的有效途径.     

影响乳腺癌复发转移的相关因素分析

目的 评价影响乳腺癌复发转移的相关因素,为临床预防及治疗提供参考依据.方法 回顾性分析2004年5月至2009年5月182例乳腺癌患者的术后临床资料,按不同的影响因素,对未发生和发生乳腺癌复发转移的病例进行统计分析.结果 年龄、淋巴结转移数、癌抗原135(CA135)等因素均与乳腺癌的复发转移有显著的相关性(P＜0.05),肿瘤直径与乳腺癌的复发转移也存在一定的联系,但单因素分析显示,肿瘤直径＞5 cm患者的复发转移率与2～5 cm患者比较差异无统计学意义(P＞0.05).Logistic多因素回归分析结果表明,与乳腺癌复发转移密切相关的因素依次是淋巴结转移数、CA135、肿瘤直径、年龄.结论 淋巴结转移数、CA135、肿瘤直径及年龄等因素均与乳腺癌的复发转移关系密切,其中淋巴结转移数是影响乳腺癌复发转移的最主要因素.     

影响外科胃癌病人住院费用因素的分析

影响外科胃癌病人住院费用因素的分析韩雷亚，罗五金胃癌是影响我国居民的主要恶性肿瘤之一，而且胃癌病人的治疗费用也在不断上涨，占用了相当一部分医疗资源。研究胃癌病人住院费用的影响因素，对控制医疗费用的膨涨和制定医院经营管理的策略均具有重要意义。材料与方法...     

女性乳腺癌危险因素的Meta分析

目的运用Meta分析方法综合分析评价国内外女性乳腺癌的危险因素。方法收集1997-2007年国内外有关乳腺癌危险因素的研究文献,采用Meta分析的随机效应模型,计算有关危险因素的比值比（odds ratio,OR）及95%可信区间（confidence interval,CI）。结果共筛选出相关文献31篇,其中,国内15篇,国外16篇。良性乳腺病史（AORs=1.95,95% CI：1.59～2.38）、乳腺癌家族史（AORs=1.58,95% CI：1.35～1.85）、绝经年龄〉50岁（ORs=1.39,95% CI：1.22～1.57）和口服避孕药（AORs=2.12,95% CI：1.24～3.62）为乳腺癌的危险因素;足月妊娠数≥1胎（AORs=0.63,95% CI：0.60～0.68）和母乳喂养（ORs=0.76,95% CI：0.64～0.90）为乳腺癌的保护因素。结论控制人群乳腺癌的发生,应从降低良性乳腺疾病、提倡母乳喂养和注意高危人群筛检等方面采取有效措施。     

胃肿瘤病人住院费用分析

当前 ,各地区医疗费用管理体制改革不断深入 ,有关疾病医疗费用的统计分析能为进一步深化医疗费用体制的改革提供有价值的参考依据 ,运用科学方法进行单病种住院医疗费用的研究 ,对有效地利用卫生资源 ,发挥其最大的医疗效益和保证医疗质量、控制医疗费用的适度增长具有重要的使用价值。因此 ,我们对大连市第三人民医院 ,大连医科大学附属二院 1999年的胃癌住院病人的费用进行调查分析 ,以对合理的制定胃癌病人的住院费用提供参考依据。资料与方法1 资料来源于病案室和住院处的原始资料 ,采用机械抽样方法 ,抽取双日出院病人 ,删除住院而未…     

死亡病人住院费用构成及其影响因素分析

世界范围内的国家卫生经费急剧上升 ,尤以医疗费用为甚 ,其增长速度超出GNP及物价指数的增长 ,已成为国家财政开支的巨大负担 ,世界各国的医疗卫生事业都面临改革。我国同样面临卫生费用上涨和资料浪费问题。死亡病人的费用控制是个敏感问题。长期以来如何合理地处理临床上难以避免死亡的危重病人或临终病人 ,依然是医院管理或医学界不敢触及的问题。受传统的医学目的或伦理思想所支配 ,医务人员不可能见死不救 ,必须千方百计地挽救生命 ,即使已处于心脏停止、或脑死亡病人 ,也要采取一切可能措施 ,不惜代价以延长生命。这样做 ,医务人员…     

影响小儿普外病人住院费用的因素分析

在儿外科病人当中 ,小儿普外病人占多数。研究小儿普外病人的住院费用及其影响因素 ,对于提高医疗质量水平 ,使科室和医院取得较好的社会效益和经济效益有实际意义。资料与方法本文资料取自某医院 1999年住院普外病人病案首页数据库 ,按照国际疾病分类法 (ＩＣＤ - 9) ,抽取有代表性的小儿普外单病种 6种 ,共 60 6例 ,调查了反映病人的身份、疾病特征及诊疗质量等 11项与住院费用相关的因素。应用ＳＰＳＳ、ＳＡＳ统计软件包处理 ,所用的统计方法有方差分析、多元逐步回归分析等。结果与分析1 小儿普外病种住院费用构成分析 (表 1)表 1　小…     

58例乳腺癌易感因素分析

[目的]研究乳腺癌的易感因素。进行有的放矢的干预性预防和有效的治疗。[方法]收集乳腺钼靶X线检查资料，病史和家族史及病理资料，分析乳腺癌的易感因素。[结果]乳腺癌的易感因素；高水平的雌激素刺激，遗传，乳腺疾病史，环境和饮食因素。[结论]乳腺癌是机体内外多种危险因素共同作用的结果。     

Cost of breast cancer in Sweden in 2002

Breast cancer is the most common cancer among Swedish women and an important cause of illness and death. The aim of this study was to estimate the total cost of breast cancer in Sweden in 2002, using a top-down prevalence-based cost-of-illness approach. The total cost of breast cancer in Sweden in 2002 was estimated at 3.0 billion SEK (1 € = 9.4 SEK). The direct costs were estimated at 895 million SEK and constituted 30% of the total cost. Indirect costs were estimated at 2.1 billion SEK and constituted 70% of the total cost. The main cost driver was production losses caused by premature mortality, amounting to 52% of the indirect costs. The reason that indirect costs were the dominant cost is because most newly detected breast cancers occur in patients aged below 65, thus causing significant production losses due to sick leave, early retirement, and premature mortality.

The costs of schizophrenia in Spain

This study estimated the economic impact of schizophrenia-related direct costs (medical and nonmedical costs) in Spain. Direct medical costs (hospitalizations, outpatient consultations, drug costs) and direct nonmedical costs (costs of informal care) were estimated based on prevalence costs for 2002. The total costs of schizophrenia were estimated at €1,970.8 million; direct medical costs accounted for 53% and informal care costs 47%. Despite having implemented a conservative approach, the health care costs associated with schizophrenia account for 2.7% of total public health care expenditure in Spain. The sum of medical and nonmedical costs give us a better definition of the magnitude of the problem in Spain as well as contributing to helping make the debate on this issue more transparent.     

Resource use and costs associated with patients treated for depression in primary care

We investigated medical resource consumption, productivity loss and costs associated with patients treated with antidepressants for depression in primary care in Sweden. Patients on treatment for depression were followed naturalistically for six months, and data on patients’ characteristics, daily activity and resource-use were collected. The total cost per patient was estimated at € 5,500 (95%CI € 5,000—6,100) over six months in 2005 prices. Direct costs were estimated at € 1,900 (€ 1,700–2,200), 35% of total costs, and indirect costs at € 3,600 (€ 3,100–4,100), 65% of total costs. The cost for antidepressants represented only 4% of the total costs. We conclude that the burden of depression is high, both to the individual as well as to wider society, and there seems to be a particular need for therapies that have the potential to improve productivity in depressed patients.      

2015—2019年江西省缺血性脑卒中患者特征及住院费用分析

目的 了解江西省2015—2019年缺血性脑卒中住院患者特征及住院费用情况，为缺血性脑卒中防控提供数据支持。方法 收集来自江西省卫生健康委员会DRGs管理系统中2015—2019年全省228家医院（69家三级综合医院，159家二级综合医院），总计381 416例出院主诊断疾病编码为I63（采用国际疾病分类第十版ICD - 10）的缺血性脑卒中患者住院信息。对住院患者特征及费用进行描述性分析。结果 2015—2019年江西省缺血性脑卒中患者,男性占比大于女性，近5年住院率由119.09/10万升高至206.61/10万。缺血性脑卒中患者最常见的共病及并发症为高血压、糖尿病、动脉粥样硬化。缺血性脑卒中次均住院费用为7 067.2(6 846.1)元，5年间，次均住院费用由7 384.0（7 353.6）元降低至6 816.9（6 769.1）元，差异具有统计学意义（H = 12.155，P＜0.002），总费用中药费占比最高，但未见明显变化趋势（H = 7.425，P = 0.063）。结论 2015—2019年江西省缺血性脑卒中住院患者住院率增长较快，高血压、糖尿病、动脉粥样硬化为3个最常见的共病,次均住院费用呈下降趋势，但住院费用负担仍较重。     

Healthcare costs associated with varicella and herpes zoster in Norway

BackgroundNorway does not implement routine vaccination against varicella or herpes zoster. Despite substantial health burden associated with both diseases, their economic impact is not well described. The aim of the present study was to document the healthcare costs associated with both conditions in a Norwegian setting.MethodsWe used registry data about patients’ contacts with primary and specialized healthcare services from 2008 to 2014 to estimate the costs associated with varicella and herpes zoster in the primary and hospital care sector. We calculated the individual costs by treatment facility (general practitioner and emergency primary care clinic) in primary care and by treatment level (inpatient, outpatient or ambulatory treatment) at hospitals.ResultsWe estimate that the annual healthcare cost of patients with varicella and herpes zoster are NOK 85 million (approximately € 9 million). Of the annual costs, 73% are associated with herpes zoster and 27% are due to varicella. The majority (54%) of the total annual cost is represented by patients with herpes zoster treated in hospital.ConclusionVaricella and herpes zoster impose a substantial financial burden on the national healthcare services in Norway. Most of the costs are incurred by herpes zoster, which could be prevented by vaccination.     

Social costs of untreated opioid dependence

Using cost-of-illness methodology applied to a comprehensive survey of 114 daily opiate users not currently in or seeking treatment for their addiction, we estimated the 1996 social costs of untreated opioid dependence in Toronto (Ontario, Canada). The survey collected data on social and demographic characteristics, drug use history, physical and mental health status, the use of health care and substance treatment services, drug use modality and sex-related risks of infectious diseases, sources of income, as well as criminality and involvement with the law enforcement system. The annual social cost generated by this sample, calculated at Canadian $5.086 million, is explained mostly by crime victimization (44.6%) and law enforcement (42.4%), followed by productivity losses (7.0%) and the utilization of health care (6.1%). Applying the $13,100 cost to the estimated 8,000 to 13,000 users and 2.456 million residents living in Toronto yields a range of social cost between $43 and $69 per capita.     

The socioeconomic costs of mental illness in Spain

Mental illness affects a large number of people in the world, seriously impairing their quality of life and resulting in high socioeconomic costs for health care systems and society. Our aim is to estimate the socioeconomic impact of mental illness in Spain for the year 2002, including health care resources, informal care and loss of labour productivity. A prevalence-based approach was used to estimate direct medical costs, direct non-medical costs, and loss of labour productivity. The total costs of mental illness have been estimated at 7,019 million euros. Direct medical costs represented 39.6% of the total costs and 7.3% of total public healthcare expenditure in Spain. Informal care costs represented 17.7% of the total costs. Loss of labour productivity accounted for 42.7% of total costs. In conclusion, the costs of mental illness in Spain make a considerable economic impact from a societal perspective.