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美国医院肺癌患者的合并症是否与医疗费用差异有关?重点关注患者和社会经济因素的差异。

Are comorbidities associated with differences in healthcare charges among lung cancer patients in US hospitals? Focusing on variances by patient and socioeconomic factors.

机构信息

Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA.

Department of Health Administration and Management, College of Medical Science, Soonchunhyang University, Asan, Republic of Korea.

出版信息

Chronic Illn. 2024 Sep;20(3):434-444. doi: 10.1177/17423953241241759. Epub 2024 Mar 27.

Abstract

OBJECTIVE

The clinical aspects of lung cancer patients are well-studied. However, healthcare charge patterns have yet to be explored through a large-scale representative population-based sample investigating differences by socioeconomic factors and comorbidities.

AIM

To identify how comorbidities associated with healthcare charges among lung cancer patients.

METHODS

We examined the characteristics of the patient sample and the association between comorbidity status (diabetes, hypertension, or both) and healthcare charge. Multivariate survey linear regression models were used to estimate the association. We also investigated sub-group association through various patient and socioeconomic factors.

RESULTS

Of 212,745 lung cancer patients, 68.5% had diabetes and/or hypertension. Hospital charges were higher in the population with comorbidities. The results showed that lung cancer patients with comorbidities had 9.4%, 5.1%, and 12.0% (with diabetes, hypertension, and both, respectively) higher hospital charges than those without comorbidities. In sub-group analysis, Black patients also showed a similar trend across socioeconomic (i.e. household income and primary payer) and racial (i.e. White, Black, Hispanic, and Asian/Pacific Islander) factors.

DISCUSSION

Black patients may be significantly financially burdened because of the prevalence of comorbidities and low-income status. More work is required to ensure healthcare equality and promote access to care for the uninsured, low-income, and minority populations because comorbidities common in these populations can create more significant financial barriers.

摘要

目的

肺癌患者的临床方面已有大量研究。然而,通过大规模的基于代表性人群的样本,调查社会经济因素和合并症差异,尚未探索医疗保健费用模式。

目的

确定与肺癌患者医疗费用相关的合并症。

方法

我们研究了患者样本的特征以及合并症状况(糖尿病、高血压或两者兼有)与医疗费用之间的关联。使用多元调查线性回归模型来估计相关性。我们还通过各种患者和社会经济因素调查了亚组相关性。

结果

在 212745 例肺癌患者中,68.5%有糖尿病和/或高血压。合并症患者的住院费用较高。结果显示,患有合并症的肺癌患者的住院费用比无合并症的患者分别高出 9.4%、5.1%和 12.0%(分别患有糖尿病、高血压和两者兼有)。在亚组分析中,黑人群体在社会经济(即家庭收入和主要支付人)和种族(即白种人、黑种人、西班牙裔和亚洲/太平洋岛民)因素方面也表现出类似的趋势。

讨论

由于合并症的高发和低收入状况,黑人群体可能会受到严重的经济负担。需要做更多的工作来确保医疗保健的平等,并为未保险、低收入和少数民族群体提供获得医疗保健的机会,因为这些人群中常见的合并症会造成更大的经济障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcb1/11562292/cfc42bcb6140/10.1177_17423953241241759-fig1.jpg

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