| Objectives(1)Investigate the utilization of health services and the economic burden of esophageal cancer inpatients;(2)Analyze the main factors affecting the incidence of esophageal cancer;(3)Analyze the psychological and behavioral coping defects of esophageal cancer patients;(4)Formulate a set of targeted psychological and behavioral intervention programs for patients with esophageal cancer.Methods(1)Using the literature reviewing and expert consulting to obtain effective information on the influencing factors of esophageal cancer patients and the formulation of intervention programs,and using the method of household survey to investigate the socio-demographic information,self-care and eating habits of the esophageal cancer patients included in the study collect data from other aspects,selecting some patients in the above pilots to conduct qualitative interviews,and finding the patients’ deficiencies in response;(2)Using Epidata3.1 to build a database and perform data entry work,and importing the entered data into SPSS16.0 for processing analysis.Using the chi-square test to analyze the differences in the number of hospitalizations of patients with esophageal cancer in different years in different technical level hospitals in the new rural cooperative medical care data,and using the Kruskal-Wakkis H test to analyze the differences and differences in the average number of hospitalization days for esophageal cancer patients in various levels of hospitals In the case-control study,the single factor analysis adopted the chi-square test,the multi-factor analysis adopted the multiple logistic regression analysis,and the rest of the current situation analysis adopted the descriptive analysis method.(3)According to the above analysis results,according to the CAPS model and the KAP model,develop psychological and behavioral intervention programs for patients with esophageal cancer.Results(1)The study collected a total of 28,065 esophageal cancer hospitalization data included in the new rural cooperative reimbursement system,randomly selected 215 esophageal cancer cases from three general hospitals,a case-control study of 61 esophageal cancer cases,183 controls,and a baseline of qualitative interviews of 33 inpatients with clinical esophageal cancer;(2)Of all the patients included in the reimbursement,21780(77.6%)chose to seek treatment in tertiary hospitals.From 2013 to 2017,the average number of hospitalization days for patients in first-level hospitals decreased year by year,and the average number of hospitalization days for patients who chose to see third-level hospitals from 2014 to 2016 was the highest;(3)From 2013 to2017,patients’ total medical expenses spent on clinics in tertiary hospitals are the highest.Among the various medical expenses of inpatients in different years and different levels of hospitals,the proportion of drugs and materials cost are always relatively high.In the cost composition of patients in various levels of hospitals,the cost of medicine,materials,laboratory tests and inspections account for a larger proportion.Since the recorded data of medical records are mostly concentrated in secondary hospitals,the composition of patient expenses is similar to the composition of secondary hospitals in the new rural cooperative reimbursement system.In 2014-2017,the proportion of per-case personal out-of-pocket expenditures per patient to rural per capita disposable income and the proportion of per-case total medical expenses to rural per capita disposable income of the year showed a downward trend,but it was still relatively high,which is catastrophic health expenditure.(4)In the univariate analysis that affects the incidence of esophageal cancer,once felt food reflux or acid reflux,dysphagia,frequent consumption of pickled foods,frequent spicy food,leftovers,and intake of multiple salt foods,Eating too fast,long-term drinking,smoking,long-term exposure to pesticides,long-term exposure to soot,long-term exposure to domestic animals or pets,pollution sources near the house,easy to get sulky,buried in the heart,often anxious,worrying about the incidence of esophageal cancer patients The risk factors for AIDS,have been diagnosed with hyperlipidemia,frequent insomnia and dreams,poor appetite,have been diagnosed with chronic gastritis,long-term consumption of soy products,drinking milk,long-term drinking well water,long-term tap water are protective factors,in the multiple logistic regression analysis Frequent food reflux or acid reflux,frequent difficulty swallowing,frequent leftovers,heavy salt,long-term smoking,frequent contact with domestic animals or pets,and frequent anxiety are risk factors for the onset of esophageal cancer,and frequent insomnia and dreams.Diagnosed chronic gastritis,frequent consumption of soy products,and long-term drinking of tap water are protective factors for the onset of esophageal cancer;(5)There are 21 patients who participated in the qualitative interview did not take it seriously after finding the relevant symptoms,and more than half of the patients found the symptoms Seek diagnosis and treatment more than a week later.More than 70% of patients usually do not pay attention to changes in their body.Most patients tend to be passive during the diagnosis and treatment process.More than half of the patients did not form a healthy lifestyle before the diagnosis.The diagnosis of cancer causes negative emotions such as anxiety and fear.Conclusions(1)The number of esophageal cancer patients included in the New Rural Cooperative Medical System is increasing year by year,and the number of patients who choose to seek treatment in tertiary hospitals also shows an upward trend year by year.Most patients prefer to choose tertiary hospitals,so the average number of hospitalization days in tertiary hospitals is the highest;(2)The total medical expenses of patients in tertiary hospitals are the highest,and the cost of medicine is always the highest proportion of the total medical expenses.In addition,material costs,inspection fees,and laboratory test fees also account for a large proportion of the total medical expenses;(3)The proportion of personal out-of-pocket expenses in the per capita disposable income and the proportion of total medical expenses in the per capita disposable income are both It has been declining year by year,but it is still high,which constitutes catastrophic health expenditure and brings an extremely heavy economic burden to people;(4)There are many factors influencing the incidence of esophageal cancer,and it is necessary to start from many aspects,and targeted intervention and improvement The psychology and behavior of patients promote the formation of good behavior habits and mental health;(5)Patients with esophageal cancer have relatively weak awareness of medical treatment and literacy,and their psychological and behavioral coping defects need to be improved;(6)This study is based on CAPS The theory and the theory of knowledge,belief,behavior and preliminarily established a set of intervention programs for the psychology and behavior of patients with esophageal cancer. |
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