Abstract: Background　Although the incidence of cancer continues to rise in China，and the number of cancer patients admitted by grade A tertiary hospitals is limited due to insufficient beds，hospital-at-home，providing hospital-level care in a patient's home，can be used as an appropriate substitute for hospital care for end-stage cancer patients.Objective　 To investigate the status of hospital-at-home delivered by Department of Oncology，Dongshi Central Hospital，and to analyze the hospitalization expenses and use of opioid analgesics of the patients，providing a basis for the development of hospital-at-home schemes.Methods　 We enrolled 225 cancer patients who received hospital-at-home delivered by Department of Oncology，Dongshi Central Hospital during April 2015 to December 2017.We conducted a retrospective analysis of the establishment of hospital-at-home，the general clinical data of patients，participation in medicai hospitalization（total expenses，individual payment excluding reimbursement，individual payment ratio，reimbursement ratio），and use of opioid analgesics.Moreover，we carried out telephone follow-ups to collect the data concerning the patient's survival and satisfaction with hospital-at-home.Results　 The numbers of cancer patients receiving hospital-at-home from April to December 2015，in 2016 and insurance and payment methods，2017 were 66，68，91，respectively.Compared with 2015（from April to December），the number of patients receiving hospital-at-home showed 103.03%，and 137.88% development speed in 2016，2017，respectively，increasing by 3.03%，37.88%，respectively.Of these totaled 225 patients，men outnumbered women〔85.3%（192/225） vs 14.7%（33/225）〕；and 38.2%（86 cases） aged 60 years or younger.216 out of 225 patients in hospital-at-home participated in the new rural cooperative medical insurance and reimbursed according to the prescribed proportion.Within this period，average individual payment excluding reimbursement，average total hospitalization expenses，and average reimbursement ratio，were 195.34 yuan，3 824.24 yuan，65.37%，respectively.The doses of morphine tablets，and OxyContin used showed an increase year after year，conforming to the principle of the WHO's three-step analgesic ladder.89.1% （114/128）of the patients or their family members were fully satisfied with hospital-at-home.Conclusion　By use of hospital-at-home，these cancer patients obtained high reimbursement ratio and decreased hospitalization expenses，so the financial burden for them was reduced.Moreover，as the treatment was conducted at home，a place being more appropriate than hospital for spending the last days of life，the qualities of life of the patient and his family members were improved.In addition，their satisfaction with care was increased.

Key words: Home care services；Community health service；Fees, medical

摘要： 背景　癌症发病率持续升高，三级甲等医院接收的患者数量有限，肿瘤专科家庭病床可为终末期肿瘤患者提供一个更加合适的治疗场所。目的　分析东石中心卫生院肿瘤专科家庭病床的建立情况，分析患者住院费用及阿片类药物使用情况，为今后肿瘤专科家庭病床项目的发展提供依据。方法　回顾性收集2015年4月—2017年12月入住东石中心卫生院肿瘤专科家庭病床的225例患者，记录肿瘤专科家庭病床建立情况、患者的基本情况、参加医疗保险及付费方式、患者住院情况（总费用、自费费用、自费比例、报销比例、平均住院天数）、阿片类药物使用情况。采用电话随访患者的生存情况及对肿瘤专科家庭病床项目的满意度。结果　2015年4—12月、2016年、2017年肿瘤专科家庭病床分别入住66、68、91例患者。2016、2017年肿瘤专科家庭病床入住患者数发展速度分别为103.03%、137.88%，增长速度分别为3.03%、37.88%。225例患者中男192例（85.3%），女33例（14.7%）。≤60岁患者86例（38.2%）。225例家庭病床患者中216例参加新型农村合作医疗保险，按规定比例报销。3年内225例肿瘤专科家庭病床患者，平均住院费用为3 824.24元，平均自费费用为1 195.34元，平均报销比例为65.37%。吗啡即释片、奥施康定使用量逐年增加，符合世界卫生组织（WHO）三阶梯用药原则。89.1%（114/128）的患者或家属对肿瘤专科家庭病床项目的满意度为完全满意。结论　东石中心卫生院肿瘤专科家庭病床患者报销比例较高，住院费用降低，减轻了患者的经济负担；肿瘤专科家庭病床为终末期肿瘤患者提供更合适的临终场所，可提高患者及家属的生存质量，提高满意度。

关键词: 家庭医疗保健服务；社区卫生服务；费用, 医疗