食管癌患者住院费用影响因素的通径分析  

Path analysis of influencing factors of the hospitalization costs of patients with esophageal cancer

作　　者：张岩曦[1] 赵妍[1] 赵二江 陆维权 

机构地区：[1]郑州大学公共卫生学院流行病与卫生统计学教研室,河南省郑州450001 [2]郑州大学附属肿瘤医院病案统计室 [3]河南省肿瘤研究院卫生统计室

出　　处：《中国慢性病预防与控制》2014年第6期694-696,共3页Chinese Journal of Prevention and Control of Chronic Diseases

摘　　要：目的探讨食管癌患者住院费用的影响因素,为合理控制医疗费用的过快增长提供依据。方法收集某省级肿瘤专科医院2006-2012年7年间共计8 068例食管癌患者的病历,运用通径分析方法探讨食管癌患者住院费用的影响因素。结果住院天数的直接效应为0.873,是影响住院费用最主要的直接因素;职业和性别直接影响住院费用,直接通径系数为-0.042和-0.009;医疗付款方式间接影响住院费用,效应值为0.084;住院科室、转归情况、手术与否、合并症数量、肿瘤部位、住院年份等因素既可直接影响住院费用,又通过住院天数间接影响住院费用,总效应分别为0.416、-0.395、0.322、0.110、-0.060和-0.038。结论有关部门需采取综合措施,规范临床路径,合理控制药价,提高医疗服务质量,有效控制住院费用过快增长。Objective To explore the influencing factors of the hospitalization costs of patients with esophageal cancer and to provide the base for controlling the rapid growth of medical expense. Methods The effective medical records of 8 068 esophageal cancer patients were collected from a provincial cancer hospital during 2006 to 2012. Then the influence factors of the hospitalization cost were analyzed with path analysis. Results The hospitalization days was the most important direct influence factor to hospitalization costs（0.873）. Occupation and gender directly affected the hospitalization costs（direct path coefficient：-0. 042 and-0. 009）. The medical payment methods indirectly affected the hospitalization costs（ 0. 084）. Surgery, type of department, outcome of the disease, complication, tumor location and hospitalization duration could directly influence the hospitalization costs and indirectly influence the hospitalization costs by hospitalization days（0.416,-0.395, 0.322, 0.110,-0.060and-0.038）. Conclusion Hospitalization costs could be controlled by comprehensive measures including standardization of the clinical pathway, control of the drug price and improvement of the service.

关 键 词：食管癌 住院费用 影响因素 通径分析 

分 类 号：R735.1[医药卫生—肿瘤]