Liu Qiongting, Fu Rong, Jiang Yixian, Zheng Zhenquan, Hu Zhijian, He Fei
Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian Province, 350122, China.
Minjiang Teachers College, Fuzhou, Fujian Province, 350122, China.
BMC Health Serv Res. 2025 Apr 25;25(1):602. doi: 10.1186/s12913-025-12624-w.
By analyzing the medical cost index and difference trend among inpatients with lung cancer who participated in the New Rural Cooperative Medical Scheme (NRCMS) in coastal areas and inland areas of Fujian Province from 2007 to 2016, we evaluated the medical cost burden and health security level of rural lung cancer patients in Fujian Province under the background of the NRCMS.
Medical record cost data of 88,191 inpatients with lung cancer under the NRCMS were collected from medical institutions at all levels in Fujian Province from 2007 to 2016. The mean and standard deviation of total hospitalization expenses, average daily hospitalization expenses, reimbursement ratio, and OOP ratio (the ratio of out-of-pocket expenditure and disposable income) for lung cancer patients in coastal areas and inland areas during 2007-2016 were calculated. After adjusting for sex, age, length of stay, and hospital level, the relative differences with 95% confidence intervals (CI) between coastal and inland areas in various cost indicators were calculated using generalized linear models to assess the trends in the differences over time.
We found differences in the total hospitalization cost, average daily hospitalization cost, reimbursement ratio, and OOP ratio of lung cancer patients in coastal areas and inland areas of Fujian Province. The burden of medical expenses for lung cancer patients in coastal areas is relatively greater than that in inland areas. From 2007 to 2011, the difference in medical expenses for inpatients with lung cancer in coastal areas and inland areas gradually narrowed. However, from 2012 to 2014, the difference in medical expenses between the two regions gradually widened. From 2014 to 2016, the difference between the two regions gradually narrowed again, and in 2016, it returned to the difference level between the two regions in 2010.
Under the influence of the NRCMS, the hospitalization cost, average daily hospitalization cost, and OOP ratio of lung cancer patients in coastal areas were higher than those in inland areas from 2007 to 2016, but the reimbursement ratio was lower. In general, the medical expenses of lung cancer patients in coastal areas of Fujian Province are greater than those in inland areas, which may be affected by differences in the level of hospitals, treatment methods, drug scope, expected survival level, and medical assistance policies of lung cancer patients in the two regions.
通过分析2007年至2016年福建省沿海地区和内陆地区参加新型农村合作医疗（新农合）的肺癌住院患者的医疗费用指数及差异趋势，评估新农合背景下福建省农村肺癌患者的医疗费用负担和健康保障水平。
收集2007年至2016年福建省各级医疗机构88191例新农合肺癌住院患者的病历费用数据。计算2007 - 2016年沿海地区和内陆地区肺癌患者的总住院费用、日均住院费用、报销比例和自付比例（自付支出与可支配收入之比）的均值和标准差。在调整性别、年龄、住院天数和医院级别后，使用广义线性模型计算沿海和内陆地区各费用指标之间的相对差异及95%置信区间（CI），以评估差异随时间的变化趋势。
我们发现福建省沿海地区和内陆地区肺癌患者的总住院费用、日均住院费用、报销比例和自付比例存在差异。沿海地区肺癌患者的医疗费用负担相对高于内陆地区。2007年至2011年，沿海地区和内陆地区肺癌住院患者的医疗费用差异逐渐缩小。然而，2012年至2014年，两个地区的医疗费用差异逐渐扩大。2014年至2016年，两个地区的差异再次逐渐缩小，2016年恢复到2010年两个地区的差异水平。
在新农合的影响下，2007年至2016年沿海地区肺癌患者的住院费用、日均住院费用和自付比例高于内陆地区，但报销比例较低。总体而言，福建省沿海地区肺癌患者的医疗费用高于内陆地区，这可能受到两个地区医院水平、治疗方法、药品范围、预期生存水平和肺癌患者医疗救助政策差异的影响。
