2016—2020年四川省504例棘球蚴病患者住院费用及补助情况分析

doi:10.12140/j.issn.1000-7423.2021.02.006

中国寄生虫学与寄生虫病杂志 ›› 2021, Vol. 39 ›› Issue (2): 161-165.doi: 10.12140/j.issn.1000-7423.2021.02.006

• 四川省棘球蚴病从流行走向基本控制的专题报道 • 上一篇下一篇

2016—2020年四川省504例棘球蚴病患者住院费用及补助情况分析

姚人新¹(), 钟波¹^,^*(), 王谦¹, 张宇¹, 刘军², 李永忠³, 周果², 赵俊彬⁴, 丹巴泽里⁵, 朱润懋⁶, 张格机², 刘阳¹, 黄燕¹, 喻文杰¹, 何伟¹, 廖沙¹, 张光葭¹, 王奇¹, 杨柳¹, 李汭芮¹

1 四川省疾病预防控制中心,成都 610041
2 四川省人民医院,成都 610072
3 四川大学华西医院,成都 610041
4 四川省甘孜州卫生健康委员会,甘孜 626000
5 四川省甘孜州疾病预防控制中心,甘孜 626000
6 四川省阿坝州疾病预防控制中心,阿坝 624000

收稿日期:2021-01-15 修回日期:2021-03-07 出版日期:2021-04-30 发布日期:2021-04-30
通讯作者: 钟波
作者简介:姚人新（1990-）,女,本科,初级医师,从事棘球蚴病防治研究。E-mail： 448312730@qq.com
基金资助:
四川省科技计划项目(2018SZ0116)

Analysis of hospitalization expenses and subsidies for echinococcosis patients in Sichuan Province during 2016—2020

YAO Ren-xin¹(), ZHONG Bo¹^,^*(), WANG Qian¹, ZHANG Yu¹, LIU Jun², LI Yong-zhong³, ZHOU Guo², ZHAO Jun-bin⁴, DANBA Ze-li⁵, ZHU Run-mao⁶, ZHANG Ge-ji², LIU Yang¹, HUANG Yan¹, YU Wen-jie¹, HE Wei¹, LIAO Sha¹, ZHANG Guang-jia¹, WANG Qi¹, YANG Liu¹, LI Rui-rui¹

1 Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
2 Sichuan People’s Hospital, Chengdu 610072, China
3 West China Hospital of Sichuan University, Chengdu 610041, China
4 Ganzi Health Commission, Ganzi 620000, China
5 Ganzi Center for Disease Prevention and Control, Ganzi 620000, China
6 Aba Centre for Disease Control and Prevention, Aba 624000, China

Received:2021-01-15 Revised:2021-03-07 Online:2021-04-30 Published:2021-04-30
Contact: ZHONG Bo
Supported by:
Sichuan Science and Technology Project(2018SZ0116)

摘要/Abstract

摘要：

目的了解棘球蚴病防治项目实施对四川省棘球蚴病患者治疗费用的影响,为制定棘球蚴病救助政策提供参考。方法收集2016—2020年四川省4所三甲医院棘球蚴病外科治疗病例的资料,包括患者的基本信息、病灶分型、住院天数、手术费用、医保补助、国家项目补助等资料信息。采用SPSS 18.0统计学软件进行统计分析。结果收集的504例病例资料中,男女性别比为1 ∶ 1.2,细粒棘球蚴病（114例）和多房棘球蚴病（175例）分型比为1 ∶ 1.5,平均年龄（38.6 ± 14.5）岁。手术部位以肝脏为主90%（414/460）。手术方式以肝部分切除为主24.7%（90/365）,合并其他手术的病例82例,肝移植病例33例。住院时间天数中位数为15 d。2016年与2020年相比中位数住院总费用由41 234元上升为66 356元,呈逐年上升趋势（P < 0.01）。不同医院、年度、手术年龄、住院时间、棘球蚴病分型及手术方式对住院总费用有影响(P < 0.05)。补助数据完整的237例患者中,住院费用总额为16 833 040元,住院费用中位数为51 172元,国家棘球蚴病项目补助金总额为4 645 709元,中位数22 000元,补助 > 20 000元者占51.9%;医疗保险和棘球蚴病项目救助后,需自付医疗费用的病例192例,合计金额2 710 793元,中位数5 888元,自付0~5 000者最多（58.2%）,其中47人零支付。结论国家棘球蚴病救治项目很大程度上减轻了患者的医疗费用负担。

关键词: 四川省, 棘球蚴病, 治疗负担, 影响因素

Abstract:

Objective To evaluate the impact of the echinococcosis prevention and treatment project on the treatment cost for echinococcosis patients in Sichuan Province, in order to provide a scientific basis for the formulation of subsidy policy. Methods Data of surgical treatment of echinococcosis patients in four 3A grade hospitals in Sichuan Province from 2016 to 2020 were collected, including the basic information, lesion type, hospitalization days and expenses, medical insurance subsidies, state project subsidies, etc. SPSS 18.0 statistical software was used for statistical analysis. Results A total of 504 cases were collected, with a male-to-female ratio of 1 ∶ 1.2. The ratio of cystic echinococcosis granulose(114 cases) to alveolar echinococcosis (175 cases) was 1 ∶ 1.5, and the average age was (38.6 ± 14.5) years. The main surgical site was in liver (90%, 414/460). The major operative strategy was partial hepatectomy (24.7%, 90/365). Eighty-two cases received combined surgery and 33 cases received liver transplantation. The median length of hospitalization was 15 days. From 2016 to 2020, the median of total cost of hospitalization showed a trend of yearly increase. Significant factors that influence the hospitalization expense included different hospitals, year of admission, the age upon operation, length stay in hospital, type of echinococcosis and operation method (P < 0.05). Of the 237 patients with complete subsidy data, the total cost of hospitalization was 16 833 040 yuan, with a median cost of 51 172 yuan. The total amount of the national echinococcosis subsidy project was 4 645 709 yuan, with a median of 22 000 yuan. Most of the patients received a subsidy of > 20 000 yuan (51.9%). After compensated by medical insurance and echinococcosis subsidy, 192 patients need to pay for their own cost. The total amount of self-payment was 2 710 793 yuan, with a median of 5 888 yuan. Most of the patients paid 0-5000 yuan (58.2%), with 47 patients paying no cost. Conclusion The government echinococcosis subsidy program has greatly reduced the burden of patients for medical cost.

Key words: Sichuan Province, Echinococcosis, Treatment burden, Influencing factors

中图分类号:

R532.32

姚人新, 钟波, 王谦, 张宇, 刘军, 李永忠, 周果, 赵俊彬, 丹巴泽里, 朱润懋, 张格机, 刘阳, 黄燕, 喻文杰, 何伟, 廖沙, 张光葭, 王奇, 杨柳, 李汭芮. 2016—2020年四川省504例棘球蚴病患者住院费用及补助情况分析[J]. 中国寄生虫学与寄生虫病杂志, 2021, 39(2): 161-165.

YAO Ren-xin, ZHONG Bo, WANG Qian, ZHANG Yu, LIU Jun, LI Yong-zhong, ZHOU Guo, ZHAO Jun-bin, DANBA Ze-li, ZHU Run-mao, ZHANG Ge-ji, LIU Yang, HUANG Yan, YU Wen-jie, HE Wei, LIAO Sha, ZHANG Guang-jia, WANG Qi, YANG Liu, LI Rui-rui. Analysis of hospitalization expenses and subsidies for echinococcosis patients in Sichuan Province during 2016—2020[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2021, 39(2): 161-165.

图/表 2

表1

表2

参考文献 16

[1]	Zhong B, Wang Q. Comprehensive prevention and treatment of echinococcosis, helping Shiqu to achieve prosperity[J]. Mod Prev Med, 2020,47(24):4417-4421. (in Chinese)
	( 钟波, 王谦. 综合防治包虫病,助力石渠奔小康[J]. 现代预防医学, 2020, 47(24), 47:4417-4421.)
[2]	Wang Q, Yang L, Wang YF, et al. Disease burden of echinococcosis in Tibetan communities: a significant public health issue in an underdeveloped region of Western China[J]. Acta Trop, 2020,203:105283. doi: 10.1016/j.actatropica.2019.105283
[3]	Wang Q, Chen F, Zhang GJ, et al. A study on the transmission dynamics of some echinococcosis in Sichuan-Tibet[J]. Chin Animal Heal, 2017,19(7):19-22. (in Chinese)
	( 王谦, 陈凡, 张光葭, 等. 青藏高原四川部分包虫病传播动力学的研究[J]. 中国动物保健, 2017,19(7):19-22.)
[4]	Huang Y, Wang Q, Yi DY, et al. Prevelance investigation and evaluation of human echinococcosis in Sichuan Province[J]. J Prev Med Inf, 2012,28(8):594-597. (in Chinese)
	( 黄燕, 王谦, 易德友, 等. 四川省棘球蚴病患病情况调查及评估[J]. 预防医学情报杂志, 2012,28(8):594-597.)
[5]	He W, Liao S, Wang Q, et al. Spatial and temporal distribution of newly diagnosed echinococcosis patients in Sichuan Province from 2007 to 2017[J]. Chin J Schisto Control, 2019,31(4):393-399. (in Chinese)
	( 何伟, 廖沙, 王谦, 等. 2007—2017年四川省新发棘球蚴病患者时空分布特征[J]. 中国血吸虫病防治杂志, 2019,31(4):393-399.)
[6]	Yu WJ, Wang Q, Liao S, et al. Echinococcosis prevalence in humans in Shiqu County of Sichuan in 2017[J]. J Prev Med Inf, 2018,34(5):545-549. (in Chinese)
	( 喻文杰, 王谦, 廖沙, 等. 2017年四川省石渠县包虫病患病情况现状调查[J]. 预防医学情报杂志, 2018,34(5):545-549.)
[7]	Li RR, Yu WJ, Wang Q, et al. Dynamic observation of the ultrasonography imaging of hepatic echinococcosis patients[J]. J Prev Med Inf, 2018,34(11):1374-1383. (in Chinese)
	( 李汭芮, 喻文杰, 王谦, 等. 肝包虫病患者超声影像动态观察[J]. 预防医学情报杂志, 2018,34(11):1374-1383.)
[8]	He W, Wang Q, Huang Y, et al. Risk factors of echinococcosis in Shiqu County, Sichuan Province[J]. Chin J Parasitol Parasit Dis, 2019,37(4):428-432. (in Chinese)
	( 何伟, 王谦, 黄燕, 等. 四川省石渠县棘球蚴病流行的影响因素分析[J]. 中国寄生虫学与寄生虫病杂志, 2019,37(4):428-432.)
	( 何伟, 王谦, 黄燕, 等. 四川省石渠县棘球蚴病流行的影响因素分析[J]. 中国寄生虫学与寄生虫病杂志, 2019,37(4):428-432.)
[9]	Kasimu A, Abudusalamu A, Tuerganali A, et al. Analysis of hospital expenses for patients with end-stage hepatic alveolar echinococcosis receiving ex vivo liver resection and autotransplantation[J]. Chin J Parasitol Parasit Dis, 2020,38(1):53-57. (in Chinese)
	Kasimu A, Abudusalamu A, Tuerganali A, et al. Analysis of hospital expenses for patients with end-stage hepatic alveolar echinococcosis receiving ex vivo liver resection and autotransplantation[J]. Chin J Parasitol Parasit Dis, 2020,38(1):53-57. (in Chinese)
	( 喀斯木·艾海提, 阿卜杜萨拉木·艾尼, 吐尔干艾力·阿吉, 等. 离体肝切除和自体肝移植术治疗终末期肝多房棘球蚴病的住院医疗费用分析[J]. 中国寄生虫学与寄生虫病杂志, 2020,38(1):53-57.)
	( 喀斯木·艾海提, 阿卜杜萨拉木·艾尼, 吐尔干艾力·阿吉, 等. 离体肝切除和自体肝移植术治疗终末期肝多房棘球蚴病的住院医疗费用分析[J]. 中国寄生虫学与寄生虫病杂志, 2020,38(1):53-57.)
[10]	Zhang Y, Yang C, Wang Y, et al. Successful treatment for end stage liver alveolar echinococcosis with ex-vivo liver resection and autologous liver transplantation combined with complicated hepatic vein reconstruction[J]. Chin J Bases Clin Gen Surg, 2018,25(10):1236-1241. (in Chinese)
	Zhang Y, Yang C, Wang Y, et al. Successful treatment for end stage liver alveolar echinococcosis with ex-vivo liver resection and autologous liver transplantation combined with complicated hepatic vein reconstruction[J]. Chin J Bases Clin Gen Surg, 2018,25(10):1236-1241. (in Chinese)
	( 张宇, 杨冲, 王燚, 等. 离体肝切除和自体肝移植联合复杂肝静脉重建治疗终末期肝泡型包虫病[J]. 中国普外基础与临床杂志, 2018,25(10):1236-1241.)
	( 张宇, 杨冲, 王燚, 等. 离体肝切除和自体肝移植联合复杂肝静脉重建治疗终末期肝泡型包虫病[J]. 中国普外基础与临床杂志, 2018,25(10):1236-1241.)
[11]	Gao Y, Wu XW, Abu DWYT, et al. Clinical analysis on 21 cases of acute intrabiliary rupture of hepatic Echinococcus granulosus cyst[J]. Chin J Parasitol Parasit Dis, 2020,38(4):524-526, 528. (in Chinese)
	Gao Y, Wu XW, Abu DWYT, et al. Clinical analysis on 21 cases of acute intrabiliary rupture of hepatic Echinococcus granulosus cyst[J]. Chin J Parasitol Parasit Dis, 2020,38(4):524-526, 528. (in Chinese)
	( 高宇, 吴向未, 阿布·都瓦依提, 等. 肝细粒棘球蚴包囊急性破裂入胆道21例临床分析[J]. 中国寄生虫学与寄生虫病杂志, 2020,38(4):524-526, 528.)
	( 高宇, 吴向未, 阿布·都瓦依提, 等. 肝细粒棘球蚴包囊急性破裂入胆道21例临床分析[J]. 中国寄生虫学与寄生虫病杂志, 2020,38(4):524-526, 528.)
[12]	Cosic L, Ma R, Churilov L, et al. The financial impact of postoperative complications following liver resection[J]. Medicine (Baltimore), 2019,98(27):e16054. doi: 10.1097/MD.0000000000016054
	Cosic L, Ma R, Churilov L, et al. The financial impact of postoperative complications following liver resection[J]. Medicine (Baltimore), 2019,98(27):e16054. doi: 10.1097/MD.0000000000016054
[13]	Zhang MY, Wu WP, Guan YY, et al. Analysis on disease burden of hydatid disease in China[J]. Chin J Parasitol Parasit Dis, 2018,36(1):15-19, 25. (in Chinese)
	Zhang MY, Wu WP, Guan YY, et al. Analysis on disease burden of hydatid disease in China[J]. Chin J Parasitol Parasit Dis, 2018,36(1):15-19, 25. (in Chinese)
	( 张梦媛, 伍卫平, 官亚宜, 等. 我国棘球蚴病疾病负担分析[J]. 中国寄生虫学与寄生虫病杂志 2018,36(1):15-19,25.)
	( 张梦媛, 伍卫平, 官亚宜, 等. 我国棘球蚴病疾病负担分析[J]. 中国寄生虫学与寄生虫病杂志 2018,36(1):15-19,25.)
[14]	Si Q, Liu CH, Shao YM, et al. Influencing factors analysis on the hospitalization cost of 2 064 cases of patients with echinococcosis[J]. Chin Med Rec, 2016,17(5):52-54. (in Chinese)
	Si Q, Liu CH, Shao YM, et al. Influencing factors analysis on the hospitalization cost of 2 064 cases of patients with echinococcosis[J]. Chin Med Rec, 2016,17(5):52-54. (in Chinese)
	( 斯琴, 刘才华, 邵英梅, 等. 2064例包虫病患者住院费用影响因素分析[J]. 中国病案, 2016,17(5):52-54.)
	( 斯琴, 刘才华, 邵英梅, 等. 2064例包虫病患者住院费用影响因素分析[J]. 中国病案, 2016,17(5):52-54.)
[15]	Li BL, Wang MX, Dong YY, et al. Analysis of hospitalization expenses and subsidy of surgical treatment patients with hepatic cystic echinococcosis in county hospitals of Xinjiang[J]. Chin Med Rec, 2019,20(9):54-57. (in Chinese)
	Li BL, Wang MX, Dong YY, et al. Analysis of hospitalization expenses and subsidy of surgical treatment patients with hepatic cystic echinococcosis in county hospitals of Xinjiang[J]. Chin Med Rec, 2019,20(9):54-57. (in Chinese)
	( 李波霖, 王明霞, 董严严, 等. 新疆维吾尔自治区县级医院肝囊型包虫病患者住院费用和补助情况分析[J]. 中国病案, 2019,20(9):54-57.)
	( 李波霖, 王明霞, 董严严, 等. 新疆维吾尔自治区县级医院肝囊型包虫病患者住院费用和补助情况分析[J]. 中国病案, 2019,20(9):54-57.)
[16]	Shao J, Wang ZX, Yangdan CR, et al. Analysis of influencing factors on hospitalization expenditures of patients with alveolar echinococcosis in Qinghai-Tibet Plateau[J]. Chin J Dis Control Prev, 2018,22(2):168-172. (in Chinese)
	Shao J, Wang ZX, Yangdan CR, et al. Analysis of influencing factors on hospitalization expenditures of patients with alveolar echinococcosis in Qinghai-Tibet Plateau[J]. Chin J Dis Control Prev, 2018,22(2):168-172. (in Chinese)
	( 邵军, 王志鑫, 阳丹才让, 等. 青藏高原地区泡型包虫病患者住院费用影响因素分析[J]. 中华疾病控制杂志, 2018,22(2):168-172.)
	( 邵军, 王志鑫, 阳丹才让, 等. 青藏高原地区泡型包虫病患者住院费用影响因素分析[J]. 中华疾病控制杂志, 2018,22(2):168-172.)

变量Variable	总费用/元 Total cost /yuan
变量Variable	中位数Median	Z	P
医院Hosipital		82.628	< 0.01
A	50 057
B	62 972
C	48 463
D	33 158
年度Year		35.335	< 0.01
2016	41 234
2017	45 749
2018	48 513
2019	63 636
2020	66 356
年龄Age		6.659	< 0.05
< 40	48 990
≥ 40	52 624
性别Genda		2.352	> 0.05
男Male	49 568
女Female	51 995
住院时间Length of hospitalization		40.616	< 0.01
< 15	46 164
≥ 15	60 192
分型Disease type		26.829	< 0.01
未分型Unknown type	28 372
细粒棘球蚴病 Echinococcosis granulosa	37 146
多房棘球蚴病 Echinococcosis multilocularis	48 805
混合型Mixed type	44 035
病灶部位Location of lesion		5.598	> 0.05
肝Liver	42 795
肺Lung	73 907
其他Other	38 223
多部位Multiple sites	75 143
手术方式 Operation procedure		168.833	< 0.01
外囊剥除术 Extracystic dissection	36 241
肝部分切除术 Partial hepatectomy	44 822
内外囊切除术Internal and external cystectomy	35 153
内囊摘除术 Excision of internal capsule	30 767
经皮肝穿刺胆道引流术 PTCD	68 510
腹腔镜Peritoneoscope	50 638
根治切除术Radical excision	51 087
微波消融 Microwave ablation	24 258
肝移植Liver transplantation	162 652
合并其他手术 Mixed surgery	71 092

2016—2020年四川省504例棘球蚴病患者住院费用及补助情况分析

Analysis of hospitalization expenses and subsidies for echinococcosis patients in Sichuan Province during 2016—2020

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 2

参考文献 16

相关文章 15

编辑推荐

Metrics

本文评价

自付情况金额/元 Self-payment/Yuan	2017	2018	2019	2020	合计 Total
零自付 Zero payment	10	25	10	2	47
1~1000	0	31	14	5	50
1001~5 000	0	30	10	1	41
5 001~10 000	0	4	19	4	27
10 001~20 000	0	7	22	3	32
> 20 000	0	7	26	7	40
合计Total	10	104	101	22	237

[1]	李奔福, 杨敬, 杨金玉, 罗瑞娟, 朱斌林, 陈泰林, 张丽娟, 李雪瑶, 严信留, 字金荣, 彭佳, 王正青, 李健雄, 蔡璇, 徐倩, 吴方伟, 杨亚明. 云南省大理州棘球蚴病流行病学调查和病例回顾性分析[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(5): 573-578.
[2]	倪碧娴, 徐祥珍, 张强, 唐凤, 张嘉尧, 茅范贞, 戴洋, 刘耀宝, 曹俊. 2015—2022年江苏省棘球蚴病网络报告病例流行病学特征分析[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(5): 636-639.
[3]	封晓晓, 白玛央金, 张颋, 陆豪杰, 魏黎明. 血清IgG唾液酸化修饰在肝棘球蚴病诊断中的应用研究[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(4): 434-439.
[4]	朱爱娅, 王旭, 王江友, 王颖, 李杨, 宋珊, 耿燕, 兰子尧, 戴佳芮. 贵州省儿童多房棘球蚴病1例[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(4): 520-523.
[5]	娆琬·托勒洪, 阿不都撒拉木·阿不力克木, 杨凌菲, 陈璐, 李钊, 贾芳, 宋涛. 超声表现诊断肝多房棘球蚴病的效果评价及因素分析[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(3): 312-318.
[6]	王威, 蔡辉霞. 2020年青海省棘球蚴病监测结果[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(3): 319-324.
[7]	蒉嫣, 薛垂召, 王旭, 刘白雪, 王莹, 王立英, 杨诗杰, 韩帅, 伍卫平, 肖宁. 2021年全国棘球蚴病防治进展[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(2): 142-148.
[8]	马冰村, 刘玉英, 张甜甜, 雷雯, 马霄, 刘寿. 青海省棘球蚴病影响因素的病例对照研究[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(2): 183-191.
[9]	罗静雯, 田洪春, 铁磊, 张丽萍, 谢红, 龚希, 吴小红, 邓秀. 2016—2021年四川省人群土源性线虫感染情况分析[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(2): 192-197.
[10]	马慧, 种世桂, 陈根, 张伶慧, 秦俊梅, 赵玉敏. 多房棘球蚴病相关细胞信号通路的研究进展[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(2): 223-227.
[11]	路伟民, 杨小涛, 朱瑛, 张鸿, 李霁伟, 王艳春. 儿童肺细粒棘球蚴病1例[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(2): 253-256.
[12]	曹得萍, 毋德芳, 庞明泉, 彭小红, 李大宇, 樊海宁. 棘球蚴病患者肠道菌群差异性分析[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(1): 103-107.
[13]	段红菊, 李凌杰, 吴向林, 闫芳, 齐蓉婷, 马天波. 2016—2021年宁夏细粒棘球蚴病手术患者住院费用及其影响因素分析[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(1): 75-80.
[14]	吴向林, 闫芳, 段红菊, 齐蓉婷, 马天波, 高建炜. 2021年宁夏多房棘球蚴病流行区犬和野外宿主感染情况[J]. 中国寄生虫学与寄生虫病杂志, 2022, 40(6): 717-722.
[15]	刘玉英, 张甜甜, 马霄, 雷雯, 马冰村, 刘寿. 青海省成年人棘球蚴病防治知识知晓情况及影响因素分析[J]. 中国寄生虫学与寄生虫病杂志, 2022, 40(6): 723-729.