以临床路径为基础的大肠癌诊疗费用探讨  

Discussions on the medical expenses of colorectal cancer based on clinical pathway

作　　者：贾慧殉[1] 谢静[1] 吴毓[1] 袁晶[1] 朱骥[1] 郭小毛[1] 

机构地区：[1]复旦大学附属肿瘤医院,复旦大学上海医学院肿瘤学系,上海200032

出　　处：《中华医院管理杂志》2013年第10期745-749,共5页Chinese Journal of Hospital Administration

基　　金：上海申康医院发展中心临床管理优化项目（SHDC2011634）

摘　　要：目的在临床路径的基础上，探讨影响大肠癌医保患者诊疗费用的主要因素，并根据影响因素对其临床路径进行优化，以降低大肠癌诊疗的医疗费用。方法选择复旦大学附属肿瘤医院2009至2010年2年间出院的大肠癌医保患者作为研究对象，共计467人。应用逐步多元线性回归分析的方法，筛选和确定影响诊疗费用的关键因素；将现有的临床路径进行优化，并对优化前后的诊疗费用进行比较。结果发现住院天数、有无并发症合并症是影响大肠癌医保患者总的诊疗费用的关键因素；而临床路径的优化均能不同程度地降低大肠癌的诊疗费用。结论主要结果可为医院大肠癌单病种付费提供依据，同时为医保基金的支付提供参考，对切实减轻患者经济负担具有重要的现实意义。Objective To explore the main factors affecting medical expenses of patients with colorectal cancer（CRC）and reduce such expenses by optimizing the clinical pathway of CRC according to the influencing factors. Methods Data of 467 discharged and medical insured CRC patients at Shanghai Cancer Center,Fudan University, were collected from 2009 to 2010. A multiple linear regression model was applied to analyze the influencing factors of medical expenses. The clinical pathway of CRC was optimized,and medical expenses before and after optimization were compared. Results Our data found days of stay and complications had impact on the medical expenses. Also,medical expenses were decreased accordingly with optimization of clinical pathway of CRC. Conclusion This study provides evidence for decision-making on single disease payment and medical insurance compensation on CRC. It is also meaningful to reduce the economic burden of patients with CRC.

关 键 词：临床路径 诊疗费用 大肠癌 

分 类 号：R197.1[医药卫生—卫生事业管理]