ABSTRACT
objective:To analyze the policy impact of separating drug sales from medical services on a certain oncology hospitals in Beijing,and provide the basis for further development and adjustment of the reform. Methods:Using interrupted time series segmented regression model to analyse the instant change and trend change of medical service utilization by outpatient(including tumor-specified outpatient) and overall inpatient services,especially in in-dicators of drug proportion,self-pay ratio,and so on after the reform. Results:Tumor treatment is a relative specific-ity. The proportion of previous inpatients in tumor specialized hospitals ranged between 49.31% and 49.96%, and the actual compensation rates were between 57.05% and 63.57%. In our case analysis, the expenditure of outpa-tients dropped after this reform,with RMB 4.33 monthly decline on average cost and with 2.32 percentage monthly decrease on a self-pay rate. Drug proportion was declined expectedly,and the proportion of outpatient and inpatient drugs immediately decreased by 4.63% and 2.98% respectively after the reform. Therewith consumptive material proportion was raised, and the proportion of outpatient and inpatient materials instantly increased by 0.22% and 1.17% respectively. Conclusion:As per the results of this study,the reform has weakened the economic dependence on drug income in sample hospital and reduced the burden on patients. However,tumor treatment is on rigid demand and brings about a relatively great impact on hospital's finance and medical insurance fund. The rationality regards of cost-shifting should be investigated in the long run.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the relationship of hepatitis B virus (HBV) infection and cirrhosis with liver metastasis in colorectal cancer.</p><p><b>METHODS</b>Clinical date of 1176 colorectal cancer patients undergone surgical treatment in the Peking University School of Oncology between January 1999 and August 2004 were analyzed retrospectively to investigate the impact of HBV infection and cirrhosis on the occurrence of liver metastasis and prognosis of patients.</p><p><b>RESULTS</b>The incidence of liver metastasis was 8.8% (10/114) in the HBV infection group and 23.9% (254/1062) in the non-infection group (P<0.01). The 5-year survival rates of these two groups were 54.2% and 60.7% ( P>0.05). The incidence of liver metastasis was 3.8% (1/26) in the cirrhotic group and 22.9% (263/1150) in the non-cirrhotic group (P<0.05). The 5-year survival rates of these two groups were 60.9% and 59.9% ( P>0.05).</p><p><b>CONCLUSION</b>Both hepatitis B virus infection and cirrhosis are associated with less liver metastasis in colorectal cancer, but have no impact on the survival.</p>