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目的分析北京市本地与外地肺癌患者的就诊行为、直接医疗费用和直接非医疗费用,为将来开展更大范围的筛查和早诊早治卫生决策提供依据。方法运用描述性统计分析对北京市本地与外地肺癌患者的诊疗情况和费用等进行归纳,采用卡方检验方法比较本地与外地肺癌患者病例分布差异,采用Wilcoxon秩和检验方法比较本地和外地肺癌患者的直接医疗费用与直接非医疗费用差异。结果北京市本地肺癌患者以65岁及65岁以上年龄组最多,占比约为57%,外地患者以55岁~64岁年龄组最多,占比约为36%;本地患者在综合医院的服务利用较多(约占56%),外地患者在专科医院的服务利用较多(约占87%);本地(约70%)和外地患者(约66%)均集中在临床分期的Ⅲ期和Ⅳ期,但外地患者Ⅱ期和Ⅲ期的比例均高于本地的;本地和外地患者均是单纯化疗的病例分布最多,占比分别为55%和56%;本地和外地患者的不同年龄组、不同类型医院、不同临床分期、不同治疗方式病例分布差异均有统计学意义(P≤0.001);本地和外地患者的次均直接医疗费用分别为25 329元、29 249元,次均直接非医疗费用分别为1326元、5867元。结论在京就诊的外地肺癌患者经济负担较本地患者重;与北京市本地肺癌患者相比,外地肺癌患者的诊疗需求多由肿瘤专科医院承担;外地中晚期和中年肺癌患者的跨区域医疗现象比较突出,且倾向于使用技术性较高的治疗手段。建议构建区域专科医疗中心来满足一个区域内居民的疑难危重病症的诊断与治疗。
Objective To analyze the treatment behaviors, direct medical costs and direct non-medical costs of lung cancer patients in both local and overseas areas in Beijing, and provide the basis for further screening and early diagnosis and early diagnosis hygiene decisions. Methods Descriptive statistical analysis was used to summarize the diagnosis and treatment of lung cancer patients in Beijing and other places. Chi-square test was used to compare the distribution of local and foreign patients with lung cancer. Wilcoxon rank-sum test was used to compare the local and foreign patients with lung cancer The difference between direct medical costs and direct non-medical expenses. Results The local patients with lung cancer in Beijing were the most frequently aged 65 and over, accounting for about 57% of the patients. The patients in the field were most likely to be 55-54 years old, accounting for about 36%. The local patients’ services in the general hospital More patients (about 56%) use more services (accounting for 87%) in specialized hospitals in the field; local patients (about 70%) and field patients (66%) are concentrated in stage Ⅲ and Stage IV, but the proportion of patients in stage II and stage III were higher than those in the local area. Local and foreign patients were mostly treated with chemotherapy alone, accounting for 55% and 56% respectively. Local and foreign patients of different age groups (P≤0.001). The average direct medical costs of local and overseas patients were 25 329 yuan and 29 249 yuan, respectively, which were all directly non-trivial Medical costs were 1326 yuan, 5867 yuan. Conclusions The cost of field lung cancer patients in Beijing is heavier than that of local patients. Compared with local patients with lung cancer in Beijing, the demand for diagnosis and treatment of lung cancer patients in foreign countries is mostly borne by cancer hospitals. The trans-regional medical phenomenon of lung cancer patients in middle- Prominent, and tend to use more technical means of treatment. It is suggested to construct a regional specialized medical center to meet the diagnosis and treatment of difficult and critical illness in residents of a region.