关键词: 尘肺病, 医疗费用, 影响因素

Abstract: Objective To explore the current situation and factors influencing medical costs of pneumoconiosis patients in Yantai City,and to provide a scientific basis for implementing targeted interventions. Methods In the database of current cases of occupational pneumoconiosis diagnosed in Yantai City from 1949 to 2020,300 cases were stratified by disease duration as the case group,and 600 cases of the same sex and age difference of not more than 3 years were the control group. The general information questionnaire was used to survey the study population,the data was analyzed. Results Pneumoconiosis patients had higher annual medical costs than the control group population,the difference was statistically significant（P<0.05）. The annual medical costs of patients were concentrated within 1.0 million yuan. The annual medical costs 0-<0.2 million yuan accounted for 44.0% of the total,0.2-<1.0 million yuan accounted for 43.0% of the total,≥1.0 million yuan accounted for 13.0% of the total. Pneumoconiosis comorbidity,annual hospitalization days and worker's injury insurance were the main factors influencing the annual medical costs of pneumoconiosis patients（all P<0.05）. Patients with a comorbidity were 45.047 times more likely to have annual medical costs ≥1.0 million yuan than those without comorbidities. Patients with ≥20 days of hospitalization per year were 204.728 times more likely to have annual medical costs 1.0 million yuan than those who were not hospitalized. Patients with workers' compensation insurance only were 22.728 times more likely to have annual medical costs ≥1.0 million yuan than those with medical insurance only. Rehabilitation training was a protective factor for annual medical costs of pneumoconiosis patients（P<0.05）,patients with 1-<3 months of annual rehabilitation training were 0.016 times more likely to have annual medical costs ≥1.0 million yuan than those who had not undergone rehabilitation training. Conclusions The medical costs of pneumoconiosis patients in Yantai are significantly higher than those of the general population,the main influencing factors are pneumoconiosis comorbidity,number of days of hospitalization per year,workers' injury insurance,and rehabilitation training.Active rehabilitation training,prevention of pneumoconiosis comorbidities,and further improvement of worker's injury insurance policies and rehabilitation training operation mechanisms can effectively reduce medical costs for patients.

Key words: Pneumoconiosis, Medical costs, Influencing factors