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ORIGINAL ARTICLE
Year : 2018  |  Volume : 131  |  Issue : 4  |  Page : 389-394

Cost Analysis of Cervical Cancer Patients with Different Medical Payment Modes Based on Gamma Model within a Grade A Tertiary Hospital


Department of Medical Administration, Beijing Hospital, National Center of Gerontology, Beijing 100730, China

Correspondence Address:
Dr. Qi Pan
Department of Medical Administration, Beijing Hospital, National Center of Gerontology, Beijing 100730
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0366-6999.225052

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Background: Cervical cancer shows a growing incidence and medical cost in recent years that has increased severe financial pressure on patients and medical insurance institutions. This study aimed to investigate the medical economic characteristics of cervical cancer patients with different payment modes within a Grade A tertiary hospital to provide evidence and suggestions for inpatient cost control and to verify the application of Gamma model in medical cost analysis. Methods: The basic and cost information of cervical cancer cases within a Grade A tertiary hospital in the year 2011–2016 were collected. The Gamma model was adopted to analyze the differences in each cost item between medical insured patient and uninsured patients. Meanwhile, the marginal means of different cost items were calculated to estimate the influence of payment modes toward different medical cost items among cervical cancer patients in the study. Results: A total of 1321 inpatients with cervical cancer between the 2011 and 2016 were collected through the medical records system. Of the 1321 cases, 65.9% accounted for medical insured patients and 34.1% were uninsured patients. The total inpatient medical expenditure of insured patients was RMB 29,509.1 Yuan and uninsured patients was RMB 22,114.3 Yuan, respectively. Payment modes, therapeutic options as well as the recurrence and metastasis of tumor toward the inpatient medical expenditures between the two groups were statistically significant. To the specifics, drug costs accounted for 37.7% and 33.8% of the total, surgery costs accounted for 21.5% and 25.5%, treatment costs accounted for 18.7% and 16.4%, whereas the costs of imaging and laboratory examinations accounted for 16.4% and 15.2% for the insured patient and uninsured patients, respectively. As the effects of covariates were controlled, the total hospitalization costs, drug costs, treatment costs as well as imaging and laboratory examination costs showed statistical significance. The total hospitalization costs, drug costs, treatment costs as well as imaging and laboratory examination costs of insured patient were 1.33, 1.42, 1.52, and 1.44 times of uninsured patients. Conclusions: The analysis of different payment modes toward the medical economic characteristics based on Gamma model is basically rational. Medical payment modes are having certain influence toward the hospitalization expenses of cervical cancer patients in an extent, as drug costs, treatment costs, and examination costs appear to be the main causes.

 

 Abstract in Chinese

基于Gamma模型不同支付方式宫颈癌患者的单中心费用研究

摘要

背景:宫颈癌作为一种最常见的妇科恶性肿瘤,近年来发病率不断攀升。其日益增加的医疗费用给患者和医保机构带来了重大经济压力。本研究旨在通过对某三级甲等医院不同支付方式的宫颈癌患者医疗经济学特性进行研究,以此对医疗机构就单病种费用管控提出政策建议,同时验证Gamma模型在医疗费用研究中的应用。

方法:收集某三甲医院2011-2016年间宫颈癌患者的基本信息及费用信息。应用Gamma 模型对不同支付方式患者的医疗费用项目差异进行分析。此外,研究还通过边缘均数计算不同支付方式对于宫颈癌患者不同费用项目类别的影响。

结果:研究通过医疗病案系统共收集2011-2016年1321例宫颈癌患者的基本信息。1321例患者中,65.9% 为医保患者,34.1% 为非医保患者。医保患者的平均医疗支出为29,509.1元,非医保患者平均医疗支出为22,114.3元。支付方式,治疗方法的选择以及肿瘤的复发和转移情况对于两组患者的医疗费用具有显著性影响。在具体费用类别方面,医保和非医保患者的药品费用分别占总体住院费用的37.7% 和33.8%,手术费用分别占总体的21.5% 和25.5%,治疗费用分别占18.7%和16.4%,影像检查费用分别占总体的16.4% 和 15.2%。两组患者在控制协变量后,总体住院费用,药品费用,治疗费用及影像检查费用呈现出显著性差异。医保患者的总体住院费用,药品费用,治疗费用及影像检查费用分别是非医保患者的1.33, 1.42, 1.52和1.44倍。

结论:基于Gamma模型对不同支付方式的单病种患者医疗经济学特性进行分析具有可行性。 不同的医疗支付模式对于宫颈癌患者住院费用具有一定影响,根据本研究结果,药品费用,治疗费用及影像检查费用是造成费用差异的主要因素。



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