Analysis of medical cost of echinococcosis cases and influencing factors in Henan Province during 2017—2019

doi:10.12140/j.issn.1000-7423.2021.03.005

Abstract

Abstract:

Objective To analyze the medical cost of echinococcosis patients and the influencing factors in Henan Province from 2017 to 2019. Methods The general information of echinococcosis cases of Henan Province was collected through the Chinese National Infectious Diseases Reporting System during 2017—2019. The clinical information was collected by epidemiological investigation and telephone follow-up. The epidemiological characteristics of the reported cases were analyzed with SPSS 22.0, and the rank sum test for two or multi independent samples was used to analyze the influential factors for medical expenses of echinococcosis cases.Results From 2017 to 2019, 51 echinococcosis cases were reported in Henan, of which 34 cases were imported from Xinjiang. For area distribution, the cases were predominantly distributed in Zhoukou (25.5%, 13/51), followed by Nanyang (17.7%, 9/51), Shangqiu (11.8%, 6/51) and Zhumadian (9.8%, 5/51). The male-to-female ratio was 1.8 : 1, and the age of patients was mainly in the range of 40-60 years. By analyzing the medical expenses of 40 echinococcosis cases, the medical expense ranged 0-0.6 million, with a median of 60 000 yuan. Factors that were significantly associated with medical expenses were gender, type of echinococcosis, lesion number, the occurrence of relapse, the time from onset to confirmed diagnosis, level of hospital offering diagnosis, time of referring and time of operation ( P < 0.05). Conclusion The medical cost of echinococcosis patients was related to disease progression and hospital visits in Henan Province.

Key words: Henan Province, Echinococcosis, Medical expense, Influential factor

CLC Number:

R532.32

ZHANG Ya-lan, DENG Yan, CHEN Wei-qi, ZHU Yan-kun, LIN Xi-meng, ZHANG Hong-wei. Analysis of medical cost of echinococcosis cases and influencing factors in Henan Province during 2017—2019[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2021, 39(3): 321-326.

Figures/Tables 6

Table 1

The associated factors for medical expenses on echinococcosis in Henan Province from 2017 to 2019

编码Code	变量Variable	赋值Assignment
X₁	医疗费用/万元Medical cost/Ten thousand yuan	调查所得实际花费 Actual cost
X₂	性别Gender	女 = 0,男 = 1;Femal = 0,Male = 1
X₃	年龄/岁Age/Years	实际年龄Actual age
X_3-1	年龄/等级 Age/Classification	< 20 = 1,20~40 = 2,40~60 = 3,≥ 60 = 4
X₄	职业Occupation	农民 = 1,儿童及学生= 2,其他 = 3;Farmer = 1,Children and student = 2,Others = 3
X₅	现居住地 Current living place	城市 = 0,农村 = 1;Urban = 0,Village = 1
X₆	流行病学史 History of epidemiology	无 = 0,有 = 1;No = 0,Yes = 1
X₇	疾病类型 Species for echinococcosis	细粒棘球蚴病 = 1,多房棘球蚴病 = 2;Cystic echinococcosis = 1, Alveloar echinococcosis = 2
X₈	病灶数量Lesion number	病灶的数量 The number of lesions
X_8-1	病灶数量/等级 Lesion number/Classification	1 = 1,2 = 2,≥ 3 = 3
X₉	复发Relapse	否 = 0,是 = 1;No = 0,Yes = 1
X₁₀	发病-确诊时间/d Time from onset to confirmed diagnosis/d	发病-确诊的实际天数Actual days from onset to be diagnosed
X_10-1	发病-确诊时间/等级 Time from onset to confirmed diagnosis/classification	≤30 = 1,31~90 = 2,91~365 = 3,> 365 = 4
X₁₁	初诊医院级别 Hospital level of the first visit	社区及以下级医院 = 1,市/县级医院 = 2,省级医院 = 3;The community and lower level hospital = 1,County-level hospital = 2, Provincial hospital = 3
X₁₂	确诊医院级别Level of hospital offering diagnosis	市/县级医院 = 1,省级医院 = 2;County-level hospital = 1,Provincial hospital = 2
X₁₃	转诊次数Visit number	实际就诊的次数Actual number of visits
X_13-1	转诊次数/等级Visit number/classification	0 = 0,1~2次 = 1,3次及以上 = 2;One to two times =1,Three times and more = 2
X₁₄	手术次数Operation number	实际手术次数Actual number of operations
X_14-1	手术次数/等级Operation number/classification	0 = 0,1次 = 1,2次 = 2,3次及以上= 3;Once = 1,Two times = 2,Three times and more = 3

Table 1

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医疗费用/万元 Medical cost/ Ten thousand yuan	频数 Frequency	百分比/% Percent/%	累积百分比/% Cumulative percent/%
< 1.0	5	12.5	12.5
1~	11	27.5	40.0
5~	15	37.5	77.5
10~	5	12.5	90.0
15~	4	10.0	100

特征 Features	因素 Factors	例数/例 Cases	构成比/% Constituent ratio/%	诊疗疗费用中位数/万元 Median of medical cost/Ten thousand yuan
性别Sex	男Male	25	62.5	12.0
	女Female	15	37.5	4.0
年龄Age	0~	5	12.5	6.0
	20~	7	17.5	9.0
	40~	23	57.5	4.0
	60~	5	12.5	5.0
职业Occupation	农民Farmer	25	62.5	4.0
	儿童及学生Children and Student	5	12.5	6.0
	其他Others	10	25.0	5.5
现居住地 Current living place	城市Urban	8	20.0	5.0
现居住地 Current living place	乡村Village	32	80.0	6.0
流行病学史 History of epidemiology	无No	6	15.0	5.5
流行病学史 History of epidemiology	有Yes	34	85.0	6.0
疾病类型 Species for echinococcosis	细粒棘球蚴病Cystic echinococcosis	37	92.5	5.0
疾病类型 Species for echinococcosis	多房棘球蚴病Alveloar echinococcosis	3	7.5	14.0
病灶数量Lesion number	1	23	57.5	5.0
	2	5	12.5	6.0
	≥ 3	12	30.0	10.5
复发Relapse	否No	35	87.5	5.0
复发Relapse	是Yes	5	12.5	15.0
发病-确诊时间/天 Time from onset to confirmed diagnosis	≤ 30	19	47.5	4.0
	31~90	8	20.0	8.5
	91~365	8	20.0	5.0
	> 365	5	12.5	8.0
初诊医院级别 Hospital level of the first visit	社区及以下医院 The community and lower level hospitals	10	25.0	4.5
	市/县级医院County-level hospital	22	55.0	6.0
	省级医院Provincial hospital	8	20.0	7.5
确诊医院级别 Hospital level of diagnosis	市/县级医院County-level hospital	15	37.5	3.2
确诊医院级别 Hospital level of diagnosis	省级医院Provincial hospital	25	62.5	8.0
转诊次数Visit number	0次None	11	27.5	4.0
	1~2次One to two times	13	32.5	3.0
	3次及以上Three times and more	16	40.0	8.0
手术次数 Operations number	0次None	5	12.5	0.3
	1次Once	28	70.0	6.0
	2次Two times	5	12.5	8.0
	3次及以上Three times and more	2	5.0	42.5

变量Variable	Z值Zvalue	卡方χ²	自由度df	P值Pvalue
性别Sex	-2.090			< 0.05
年龄Age		7.551	3	> 0.05
职业Occupation		3.756	3	> 0.05
现居住地Current living place	-0.306			> 0.05
流行病学史History of epidemiology	-0.114			> 0.05
疾病类型Species for echinococcosis	-2.449			< 0.05
病灶数量Lesion number		9.579	2	< 0.01
复发Relapse	-2.402			< 0.05
发病-确诊时间/天Time from onset to confirmed diagnosis/d		9.691	3	< 0.05
初诊医院级别Hospital level of the first visit		0.924	2	> 0.05
确诊医院级别Hospital level of diagnosis	-2.384			< 0.05
转诊次数Visit number		14.916	2	< 0.01
手术次数Operation number		17.253	3	< 0.01