The Epidemic Characteristics And Direct Economic Burden Evaluation Of Leukemia In1241Cases

Objectives:A retrospective investigation was conducted on the first diagnosed leukemia patients in the1st hospital of Lanzhou University, Gansu province from2003to2012, in order to explore its occurrence regularity and biological characteristics; found out the overall and internal constitutional rules, and researched the influencing factors of the direct economic burden; this study was aiming at providing basic data and reference for the three grade prevention and health administrative departments.Methods:1. Harvested1241samples, which were clinical materials from patients with leukemia and were first diagnosed in the1st hospital of Lanzhou University during January1st2003to December31th2012. Though summarizing the hospital medical records found its morphology, immunology, cytogenetics and molecular (MICM) classification, epidemiological characteristics and epidemic trend of ten years.2. According to patients’ time which was admitted to hospital, the repeat hospitalization expense was adjusted by Gansu province GDP deflator, in order to analysis the cost changing trend and main single expend on the growth of medical expenses in hospital.3. According to the professional knowledge and experience, selected hospitalization expenses and hospitalization time as endogenous variables, and other eight factors as exogenous variables, used path analysis to explore the influencing factors of economic burden of growing hospitalization cost.Results:1. In the1241cases of leukemia patients, children accounted for20.95%, adults accounted for79.05%. Childhood leukemia gave first place to ALL-centered disease, and the percent of ALL reached53.85%. Adult leukemia posed a different genre of AML, and the percentage was highest (47.70%). Young and middle-aged patients were susceptible to leukemia, while infants, kids and the aged were relatively less. Males were more susceptible than females. The differents between each seasons were little. From2003to2012, the number of person-time of leukemia patients increased year by year, the average increase rate was18.75%. The average annual growth of newly diagnosed cases of leukemia was108.08%and the growth rate was8.08%per annum.2. In the past10years, the proportion of CLL increased year by year, while the special types decreased, the differences had statistical significance (P<0.05). The proportion of Leukemia patients whose age were between35and64increased year by year, while the0-14year and15～34year groups decreased, the differences had statistical significance (P<0.05). Males were higher than females over the years. The proportion of patients who came from the city except lanzhou increased year by year, while the patients who came from lanzhou decreased, the differences had statistical significance (P<0.05). The proportion of person-time of leukemia patients increased year by year, the differences had statistical significance (P<0.05), but the number of newly diagnosed cases had no significant changing trend (P>0.05).3. No matter children or adults patients’expense in hospital, medicinecharges were both at the first place, diagnosis costs were at the second place, the treantment costs and comprehensive service fee rounded the third and the forth place. The proportion of the average hospitalization expenses of childhood leukemia increased year by year and had statistical significance (rs=0.800, P<0.05), while adults leukemia had no significant changes (rs=-0.594, P>0.05). Children’ average hospitalization expenses were less than adults, but this gaps reduced years by year (rs=-0.855, P<0.05).4. The hospitalization expenses’ direct effect order were hospitalization days, patients’type, drug proportion, disease’type andhospital ization time. The indirect effect of drug proportion and hospitalization time were the biggest.Conclusions:In the past ten years, the number of person-time of leukemia patients had a increasing trend, drug costs became the main source of hospitalization expenses. The factors impacted on the hospitalization expenses were multiplicity. It’s necessary to take further research.