A survey on medical expenditure of hepatic echinococcosis surgery in a Tibetan Region and the related influencing factors

Abstract

Abstract: Objective To evaluate the medical expenditure of hepatic echinococcosis surgery in Tibetan area and analyze the influencing factors, in order for setting up a reasonable range of charge for echinococcosis treatment. Methods Echinococcosis patients having received surgical treatment in a hospital in Tibetan area from February to December, 2015 were enrolled. The basic medical information including a detailed list of medical cost was obtained based on their medical record. All the patients had given consent to this study. Data were entered into Microsoft excel 2007 and analyzed with SPSS 18.0. The average medical cost per patient was calculated and its composition was analyzed. Results Forty-nine patients were included in this survey, with an average hospitalization time of 28.6 days. The auxiliary examinations except MRI were performed more than twice for each patient on average. The average medical expenditure per patient was 47 146.0 yuan(RMB). The mean expenditure of alveolar echinococcosis(AE) treatment was 60 810.7 yuan, which was significantly higher than that of cystic echinococcosis(CE, 42 211.5 yuan) (P < 0.05), and which had compositions all significantly higher than those of CE(P < 0.05). The expenditures on drugs, consumable materials, treatment fee (including surgery) and examination fee were 16 944.1 (35.9%), 12 903.0 (27.4%), 9 037.9(19.2%), and 4 823.5 yuan(10.2%), respectively, for each patient. The medical expenditure of hepatic echinococciasis increased with longer hospitalization duration. The expenditure for patients receiving ≤2 CT examinations(43 192.0 yuan) was significantly lower than those having > 2 CT examinations(53 955.7 yuan) (P < 0.05). The drug cost was the most sensitive factor that influences the overall expenditure. Conclusion The medical expenditure of echinococcosis is high. Measures are needed to decrease the expenditure, such as reasonable use of medicines and consumable materials, reasonable arrangement of auxiliary examinations and adjustment of hospitalization duration.

Key words: Echinococcosis, Surgical treatment, Medical expenditure

CLC Number:

R532.32

Meng-yuan ZHANG, Wei-ping WU, Ya-yi GUAN, Li-ying WANG. A survey on medical expenditure of hepatic echinococcosis surgery in a Tibetan Region and the related influencing factors[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2017, 35(3): 250-253.

Figures/Tables 3

Table 1

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References 22

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类型Type	患者数 No. patients	断层扫描平均次数 Frequency of CT examination	磁共振平均次数Frequency of MRI examination	数字摄影平均次数 Frequency of DR examination	多普勒超声平均次数Frequency of B ultrasound examination	生理生化检验平均项数Frequency of physiological and biochemical tests	病理检验平均次数Frequency of pathological examination	平均住院天数/d The average hospitalization duration/d
细粒棘球蚴病Cystic echinococcosis	36	2.8	0.03	3.4	4.9	21.0	3.2	26.4
多房棘球蚴病Alveolar echinococcosis	13	2.8	0.15	3.9	5.2	25.5	3.3	34.7
合计 Total	49	2.8	0.06	3.6	4.9	22.2	3.2	28.6

类型Type	药品费用/元Drug fee/yuan	耗材费用/元Consumptive material /yuan	检查费用/元Examination fee /yuan	护理费/元Nursing fee /yuan	床位费/元 Bed fee/yuan	治疗费/元Treatment fee /yuan	其他费用/元 Others/yuan	总费用/元 Total fee/yuan
细粒棘球蚴病Cystic echinococcosis	15 015.9	11 250.9	4 639.4	796.7	580.6	8 120.8	1 807.3	42 211.5
多房棘球蚴病Alveolar echinococcosis	22 283.6	17 478.1	5 333.3	1 047.4	763.2	11 577.4	2 327.6	60 810.7
合计Total	16 944.1	12 903.0	4 823.5	863.2	629.0	9 037.9	1 945.3	47 146.0

敏感性分析因素Factor	变化率/% Change ratio/%	医疗费用/元·人^-1 Medical fee/yuan per patient	费用变化率/%Change ratio of fee/%
药物费用 Drug fee	20	50 534.8	7.2
	10	48 840.4	3.6
	-10	45 451.6	-3.6
	-20	43 757.2	-7.2
耗材费用Consumptive material fee	20	49 726.6	5.5
	10	48 436.3	2.7
	-10	45 855.7	-2.7
	-20	44 565.4	-5.5
治疗费用Treatment fee	20	48 110.7	2.1
	10	47 628.3	1.0
	-10	46 663.6	-1.0
	-20	46 181.3	-2.1