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医院“潜规则”:同样病情,越胖的人收费越高!

2017-08-31 佚名 邵逸夫医院

化疗第二天,偶然间聊起费用,其中一位大吃一惊:才过了两天,自己已经比另一人足足多花了一万五!俩人赶紧拿出明细来对比,发现主要差异在药费上。

8月的同一天,邵逸夫医院肿瘤内科的一间病房同时收治了两个结肠癌晚期的女病人。俩人年龄相仿、病情相似,很快就成了同病相怜的好朋友。

化疗第二天,偶然间聊起费用,其中一位大吃一惊:才过了两天,自己已经比另一人足足多花了一万五!俩人赶紧拿出明细来对比,发现主要差异在药费上。

“同样的病怎么会差距那么大?”医生查房的时候,她们忍不住提出了疑问。

主管的李达副主任医师笑眯眯地看着其中较胖的那位,说:“该适当减肥了,因为你胖,所以收费贵!”

肥胖会给人带来多种隐形麻烦,不止经济问题

胖的人花费多

其实是医院“明规则”

平常,成人的用药剂量往往以“片”或“毫升”来计算,人与人之间差别不是很大,而且常用药价格也不高,大部分人不是特别敏感。

然而一旦需要用比较贵的药品,你就马上能感受到明显的“收费歧视”了。

前面两位患者,化疗方案相同,费用却足足差了15000多元,就是因为他们用了一种昂贵的靶向治疗药物“安维汀”。

在联合m-IFL(改良IFL)化疗方案时,每公斤体重要给5mg安维汀,每两周一次。这两位女病人,一个体重51公斤,另一个却有105公斤,属于一般人说的“超级胖”。单单安维汀一种药物,体重大的那位病人一次就得多花15894元(多3瓶)!考虑到长期治疗的话,花费更可怕!

说明

安维汀是当前较新和有效的靶向抗肿瘤药物之一,价格高达5298元/100mg,按照每公斤体重5mg计算剂量。

除了药费

肥胖的隐形成本远超你想象

肥胖是高血压糖尿病、血脂异常、冠心病、心肌梗死卒中乳腺癌等多种癌症、膝关节炎等多种疾病发生的主要危险因素。

美国健康信托和罗伯特·伍德·约翰逊基金会公布一份联合调查报告显示,全美每年因肥胖增加的医疗费用达到1470亿美元以上。而在中国,估计因肥胖所造成的经济成本已经占到中国国民生产总值的4%至8%。

而且对大多数人来说,最最最重要的应该是:在这个看脸的世界,以瘦为美的世界,一“胖”毁所有啊!

肥胖像瘟疫一样席卷全世界

这是2013年的全球超重、肥胖地图。颜色越深,肥胖率越高。中国未富先胖,横向比较还好,但纵向比较已有爆炸性增长之势。

来源:华盛顿大学的健康测量和评估研究所(IHME)

如何界定肥胖?

世界卫生组织(WHO)综合众多研究成果,推荐三套体系来测量肥胖:

一是BMI指数,作为通用指数来界定肥胖;

二是腰臀比,主要用来区别那些容易在腹部堆积脂肪的人群,也称腹胖;

三是腰围,主要适用于鸭梨型肥胖的人群,也称为中心胖。

根据腰臀比和腰围检出的腹胖和中心型肥胖者是高血压糖尿病及其他各类心血管疾病的易感人群。

BMl标准

计算方法:BMI=体重(kg)÷身高2(m2)

亚洲人的腹部更容易堆积脂肪,所以WHO推荐了的BMI亚太标准,详见下表。

腰臀比(WHR)

计算方法:WHR=腰围长度(cm)÷臀围长度(cm)

中国人其实整体偏瘦,但是腹部更容易堆积脂肪,因此需要特别关注腹胖。

男性WHR>0.9

女性WHR>0.85

即为腹胖。

中国式将军肚,相比于欧美常见的全身性肥胖,心脑血管等疾病发生率更高。

腰围长度(WC)

计算方法:测量腰围长度

中国人大肚皮的鸭梨型肥胖现象也比较普遍。

中国成年男性WC≥85cm

女性WC≥80cm

属于中心型肥胖。

这是一篇关于科学减肥的干货

不要再用“喝水也会胖”的“肥胖基因”骗自己了,基因缺陷引起的肥胖仅占5%左右,大多数人还是被自己吃胖的!

减肥的根本是保持能量摄取与消耗的平衡状态。简单地说,就是管住嘴,迈开腿。

合理饮食

关键是少摄入糖和脂肪,同时避免营养素缺乏症。

1.吃饭细嚼慢咽、不能太快。

2.吃饭之前喝点汤。

3.吃饭要七分饱。

4.多吃蔬菜等纤维食物,少吃粮食和肉类。

适度运动

要减肥的人主要推荐中等强度、较长时间的有氧运动,辅以力量性运动及球类运动等。

动力性有氧运动:长距离步行、自行车、游泳、健身操动等。

水中运动被认为是最有前途的减肥运动,除游泳外,已发展到水中行走、跑步、跳跃等。

力量性运动:仰卧起坐、下蹲起立、俯卧撑、哑铃或拉力器等运动。

球类运动:羽毛球、乒乓球、网球、篮球等。

每周3次以上、每次运动30-60分钟。

高科技个性化减肥?

究竟是什么原因导致贪吃?

脂肪细胞如何形成?

肥胖症发病前后新陈代谢如何发生改变?

其实这些问题都还没有确切的答案。

但有研究预测,5年内人们将开始利用基因、行为和其他复杂的数据制定体重管理计划,将来可以通过唾液样本进行基因测序,同时用自动化传感器收集环境、饮食、活动和压力等信息,由计算机算法获取这些信息,再给出体重管理的具体建议。

那时候,躺在床上减肥也许不再是梦哦。

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createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Fri Sep 01 19:51:43 CST 2017, time=2017-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239150, encodeId=cf0d23915014, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=550d2008262, createdName=luominglian113, createdTime=Fri Sep 01 00:17:18 CST 2017, time=2017-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239014, encodeId=3f2b2390143b, content=学习并分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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    2017-09-23 1771ae4158m

    学习一下很不错

    0

  2. 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    2017-09-13 虈亣靌

    谢谢分享谢谢分享

    0

  3. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/24/1c2dbd6706e64df33befd6663f1d6b37.jpg, createdBy=94f61661779, createdName=lyh994, createdTime=Thu Aug 31 10:58:12 CST 2017, time=2017-08-31, status=1, ipAttribution=)]
    2017-09-11 虈亣靌

    不错的.学习了!谢谢分享!

    0

  4. 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  5. 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    2017-09-02 随梦飞扬

    不要再用[喝水也会胖"的[肥胖基因"骗自己了.基因缺陷引起的肥胖仅占5%左右.大多数人还是被自己吃胖的!

    0

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createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Thu Aug 31 15:15:31 CST 2017, time=2017-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=238951, encodeId=a6e6238951e0, content=好好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K1RUfOKQohib4bXhDtxVgOA9VcKY1LUZkCOmr0v3WupxANz2ibibNHkdevtSruvrhyI29IjXdtvUV48/0, createdBy=6ff82057534, createdName=139****5926, createdTime=Thu Aug 31 11:33:47 CST 2017, time=2017-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=238918, encodeId=c67f238918f7, content=腹胖很难消.影响也很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/24/1c2dbd6706e64df33befd6663f1d6b37.jpg, createdBy=94f61661779, createdName=lyh994, createdTime=Thu Aug 31 10:58:12 CST 2017, time=2017-08-31, status=1, ipAttribution=)]
    2017-09-01 虈亣靌

    内容丰富.值得学习

    0

  7. 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createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Thu Aug 31 15:15:31 CST 2017, time=2017-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=238951, encodeId=a6e6238951e0, content=好好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K1RUfOKQohib4bXhDtxVgOA9VcKY1LUZkCOmr0v3WupxANz2ibibNHkdevtSruvrhyI29IjXdtvUV48/0, createdBy=6ff82057534, createdName=139****5926, createdTime=Thu Aug 31 11:33:47 CST 2017, time=2017-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=238918, encodeId=c67f238918f7, content=腹胖很难消.影响也很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/24/1c2dbd6706e64df33befd6663f1d6b37.jpg, createdBy=94f61661779, createdName=lyh994, createdTime=Thu Aug 31 10:58:12 CST 2017, time=2017-08-31, status=1, ipAttribution=)]
    2017-09-01 luominglian113

    学习了.谢谢分享

    0

  8. 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createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Thu Aug 31 15:15:31 CST 2017, time=2017-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=238951, encodeId=a6e6238951e0, content=好好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K1RUfOKQohib4bXhDtxVgOA9VcKY1LUZkCOmr0v3WupxANz2ibibNHkdevtSruvrhyI29IjXdtvUV48/0, createdBy=6ff82057534, createdName=139****5926, createdTime=Thu Aug 31 11:33:47 CST 2017, time=2017-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=238918, encodeId=c67f238918f7, content=腹胖很难消.影响也很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/24/1c2dbd6706e64df33befd6663f1d6b37.jpg, createdBy=94f61661779, createdName=lyh994, createdTime=Thu Aug 31 10:58:12 CST 2017, time=2017-08-31, status=1, ipAttribution=)]
    2017-08-31 大爰

    学习并分享!!

    0

  9. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/24/1c2dbd6706e64df33befd6663f1d6b37.jpg, createdBy=94f61661779, createdName=lyh994, createdTime=Thu Aug 31 10:58:12 CST 2017, time=2017-08-31, status=1, ipAttribution=)]
    2017-08-31 139****5926

    好好文章学习了

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=246874, encodeId=b0d82468e454, content=学习一下很不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/ac01daf0962458a9eb8c0b1e2f6ce5bc.jpg, createdBy=04b81710322, createdName=1771ae4158m, createdTime=Sat Sep 23 08:33:05 CST 2017, time=2017-09-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=243662, encodeId=f7dc243662b0, content=谢谢分享谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Sep 13 22:57:23 CST 2017, time=2017-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=243001, encodeId=50f5243001bd, content=不错的.学习了!谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Sep 11 23:12:54 CST 2017, time=2017-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1765022, encodeId=b8ad1e65022b7, content=<a href='/topic/show?id=df00e086653' target=_blank style='color:#2F92EE;'>#病情#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70866, encryptionId=df00e086653, topicName=病情)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Tue Feb 27 14:04:00 CST 2018, time=2018-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239523, encodeId=986b239523f8, content=不要再用[喝水也会胖"的[肥胖基因"骗自己了.基因缺陷引起的肥胖仅占5%左右.大多数人还是被自己吃胖的!, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sat Sep 02 00:32:27 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239391, encodeId=5c3423939131, content=内容丰富.值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Fri Sep 01 19:51:43 CST 2017, time=2017-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239150, encodeId=cf0d23915014, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=550d2008262, createdName=luominglian113, createdTime=Fri Sep 01 00:17:18 CST 2017, time=2017-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239014, encodeId=3f2b2390143b, content=学习并分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Thu Aug 31 15:15:31 CST 2017, time=2017-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=238951, encodeId=a6e6238951e0, content=好好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K1RUfOKQohib4bXhDtxVgOA9VcKY1LUZkCOmr0v3WupxANz2ibibNHkdevtSruvrhyI29IjXdtvUV48/0, createdBy=6ff82057534, createdName=139****5926, createdTime=Thu Aug 31 11:33:47 CST 2017, time=2017-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=238918, encodeId=c67f238918f7, content=腹胖很难消.影响也很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/24/1c2dbd6706e64df33befd6663f1d6b37.jpg, createdBy=94f61661779, createdName=lyh994, createdTime=Thu Aug 31 10:58:12 CST 2017, time=2017-08-31, status=1, ipAttribution=)]
    2017-08-31 lyh994

    腹胖很难消.影响也很多

    0

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