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

doi:10.12140/j.issn.1000-7423.2021.02.006

Abstract

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

CLC Number:

R532.32

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.

Figures/Tables 2

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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