| Objective Through the analysis of hospital fees of four common types of cancer in Lanzhou City in 11 years in a row,knowing about the cost of treatment's developing trends of the cancers, and predicting the future direct economic growth trends,which provide basic data for the prevention work of the common cancers.Methods Choosing and obtaining hospitalized cases of patients with diagnosed lung cancer, liver cancer,esophageal and gastric cancer from two hospitals in Lanzhou City from the year 1996 to 2006,gaining accesses to the information like age,gender and occupational distribution, hospital fees,etc about the four common cancers in the 11 year period.Adjusting the yearly hospital fees according to consumer price index,and then evaluating the disease burden and analyzing the cost-effectiveness.Combining exponential curve,the power curves and linear curve together to predict the number of hospitalized patients and hospitalized costs for each patient of the four kinds of cancer from the year 2007 to 2011.Results(1) In the the collected 9,772 valid cases,lung cancer accounts for 3,115 cases,liver cancer accounts for 1,135 cases,esophageal cancer accounts for 1,743 cases,gastric cancer accounts for 3,779 cases.The average age of patients with lung cancer,liver cancer,esophageal cancer, gastric cancer are 58.99±12.01,54.57±12.50,59.42±9.6,and 56.77±11.76 years old respectively,and through the trend analysis to patients constitute in each age group,there are rising trend compared with other groups whose average ages are stable.Gender distribution: There are more male patients than female patients in the four cancers.The constituent ratio of male patients to female ones shows a year-by-year rising trend,and the female patients received a more rapid growth than the male ones.There is a downward trend in the gender ratio of male patients to female ones.Occupational distribution:The occupational distribution variances of the cancers have no statistical significance(P＞0.05) except lung cancer.Through the trend analysis of each accupation of the patients with the four common types of cancer,the constituent ratio of different occupations shows a rising trend,in which lung cancer and liver cancer received a faster growth trend,and the proportion of farmers is increasing;while esophageal and gastric cancer received a slower growth trend,in which farmer esophageal cancer patients and officer gastric cancer patients are growing faster.(2) Direct economic burden of diseases:The average hospitalized costs of the lung cancer,liver cancer,esophageal cancer and gastric cancer patients are 9005.13±2.66 yuan,8981.74±2.66 yuan,8878.07±2.97 yuan,and 269.61±2.71 yuan,respectively,all of which shows a year-by-year rising trend.Hospitalized costs variance of the four cancers in different years all have statistical significance;further,each has year-by-year rising trend.All the variances of the hospitalized costs between the four cancers have statistical significance(P＜0.05).In the hospitalized cost,bed fee,western medicine fee,radiology fee,treating fee,surgical fee, inspection fee,and anesthesia fee show obvious rising trend,and other fees have no regular patterns from 1996 to 2006.(3) Analysis of the trend of hospitalized costs:①The average number of the hospitalized days and the average hospitalized costs per patient between the conservative treatment and the surgical treatment have statistical significance(P＜0.05).During the 11 years,the average number of the hospitalized days of the four cancers which were treated by the two kinds of treatment shows a downward trend and the average number of the hospitalized days of the surgical treatment have been declining more faster than that of the conservative treatment,but the average number of the hospitalized days of the surgical treatment is more;During the 11 years,the average cost per patient of the four cancers treated by the two kinds of treatment all show a rising trend,and the average cost per patient of the surgical treatment rose faster than that of the conservative treatment;②Whether having a complication or not has obvious statistical significance(P＜0.5) on the average numbers of hospitalized days and hospitalized cost per patient of the four cancers.Compared with the four cancers without complications,the average number of hospitalized days of the four cancers with complications shows a downward trend,but the average hospitalized cost shows a rising trend;③It shows statistical significance(P＜0.05) that the differences of the average number of hospitalized days,the hospitalized cost per patient and the hospitalized cost per day of the four normal cancers between different hospitals.The average number of hospitalized days of the four cancers between different hospitals shows a downward trend,the hospitalized cost per day of the four cancers between different hospitals shows rising trend and it rose faster in the comprehensive hospitals than the hospitals during the 11 years;④The average number of hospitalized days and the hospitalized cost per patient of the four cancers between different careers have statistical significance(P＜0.05).The average numbers of hospitalized days of the four cancers between different careers shows a downward trend,the hospitalized cost per patient of the four cancers between different careers shows a rising trend and the cost of the patients as leaders is always higher than the patients in other positions,their hospitalized cost also rose more slowly than others,the hospitalized cost per farmer patient rose more quickly than others;⑤the average number of hospitalized days,the hospitalized cost per patient of the four normal cancers with different medical paying ways have statistical significance(P＜0.05).The average number of hospitalized days of the four normal cancers with different medical paying ways show a downward trend,and the hospitalized cost per patient shows a rising trend,and the hospitalized cost per patient of the patients who received free medical treatments is higher than the other patients whose should pay for the treatments;⑥the hospitalized cost per patient and the hospitalized cost per day of the four normal cancers with different hospitalized days have statistical significance(P＜0.05).With the rising of the hospitalized days,the hospitalized cost per day shows a downward trend;with the rising of the hospitalized days,the hospitalized cost per patient shows a rising trend.(4) Cost-effectiveness analysis:①the hospitalized cost per patient and the hospitalized cost per day of the four normal cancers with different treatments have statistical significance(P＜0.05). The hospitalized cost per patient of the four cancers with the two different treatments all show a rising trend,and the cost of four cancers with surgical treatment rose more quickly than that with conservative treatment;②The differences of the hospitalized cost per patient and the hospitalized cost per day of the four normal cancers of different hospitals have statistical significance(P＜0.05).The cost-effectiveness ratio of the hospitalized cost per patient of the comprehensive hospitals shows a rising trend and the ratio of the comprehensive hospitals was always higher than that of special hospitals during the 11 years;The cost-effectiveness ratio of the hospitalized cost per day of the comprehensive hospitals shows a rising trend and the ratio of the comprehensive hospitals was always higher than which of special hospital during the 11 years;③The hospitalized cost per patient of the four normal cancers with different hospitalized days have statistical significance(P＜0.05).The effective ratio rise with the rising of the hospitalized days,but once the number of hospitalized days reaches to 59,the effective ratio shows a downward trend;with the increasing of the hospitalized days,the cost-effectiveness ratio of the hospitalized cost per patient shows a rising trend.(5)The prediction of incidence trend of the four cancers:It is predicted that the number of the patients with lung cancer,liver cancer,esophageal cancer,gastric cancer will reach to 821,371, 219,790 in the year 2011;And the hospitalized cost per patient of the patients with lung cancer, liver cancer,esophageal cancer,gastric cancer will reach to 11042.56yuan,17290.83yuan, 22745.67yuan,19227.22yuan in the year 2011;(6) The average increasing ratio of the four cancers per year:The average increasing ratio of the number of the patients with lung cancer,liver cancer,esophageal cancer,gastric cancer will reach to 12.04%,15.15%,2.94%,9.13%and the average increasing ratio of the hospitalized cost per patient of lung cancer,liver cancer,esophageal cancer,gastric cancer will reach to 2.38%, 8.05%,10.23%,8.34%.Conclusion(1)The number of the patients with lung cancer,liver cancer,esophageal cancer,gastric cancer shows a year-by-year rising trend,the patients of the four cancers shows a trend of getting older and the ratio of the male patients to female ones received a downward trend;(2) The hospitalized cost per patient of the four normal cancers shows a year-by-year rising trend.The hospitalized cost was obviously impacted by the differences such as different cancers,methods of treatments, hospitals,careers,hospitalized days,ways of medical payment.We should make a suitable function way which could take all kinds of facts into consideration to reduce the economic burden of the patients and the waste of the health resources;(3) The cost-effectiveness ratio of the cost of four cancers all shows a rising trend,but the effective ratio of the four cancers rises at the beginning and then slip down with the years goes on;we should try to combine the several kinds of treatments together and make an effective,standard treatment to improve the quality of the life of the patients with cancers.
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