消化系统肿瘤患者住院费用影响因素分析——基于结构方程模型的研究  

Research on Influencing Factors of Hospitalization Expenses for Patients with Digestive System Tumors:Based on Structural Equation Model

作　　者：龚霞[1] 王进申[1] 孔旭辉[1] 潘进程 黄秀芹[1] 高熹[1] GONG Xia;WANG Jin-shen;KONG Xu-hui(Taizhou People’s Hospital,Taizhou,Jiangsu,225300,China)

机构地区：[1]泰州市人民医院,江苏泰州225300

出　　处：《中国医院管理》2018年第12期80-82,共3页Chinese Hospital Management

基　　金：江苏省医院协会医院管理创新研究重点课题(JSYGY-2-2017-88)

摘　　要：目的借助结构方程模型,模拟分析某医院消化系统肿瘤患者住院费用的影响因素、因素间相互作用关系路径及影响深度,为医院控制病种费用、节约医保资金、减轻患者就医经济负担提供可操作的路径。方法采用回顾性方法,收集某医院2016年诊断为结肠癌、胃癌、食管癌3种疾病的1 454份病历资料,借助AMOS24.0分析影响住院费用的主要因素。结果结构方程模型拟合程度良好。性别(X4)和是否自费(X3)两个因素直接作用于住院费用;疾病病情(X1)既可以通过治疗方式和住院天数作用于住院费用,也可以直接作用于住院费用;治疗方式(X5)、住院天数(X6)既可以直接影响住院费用,又可以作为中介变量影响住院费用。结论疾病病情是影响住院费用的最主要因素,选取合适的治疗方式,疗效显著,并能有效降低住院费用;合理控制住院天数,通过治疗方式也可以降低和控制住院费用。Objective By building SEM,to analyze the factors affecting hospitalization expenses for patients with digestive system tumors,the interaction pathways among the factors and their influence,so as to provide a feasible pathway for hospitals to control the single disease cost and to reduce their medical expense of patients.Methods1454medical records of patients with colon cancer,gastric cancer or esophageal cancer from a comprehensive hospital in2016were collected,and the obtained data were analyzed by AMOS24.0to determine the main factors influencing the hospitalization expenses.Results The SEM proves that gender(X4)and whether at patients’own expense have direct influence on the hospitalization expenses;patients’condition(X1)can not only affect the hospitalization expenses directly,but also work with methods of treatment and duration of hospital stay;Otherwise,methods of treatment(X5)and the duration of hospital stay(X6)have direct and indirect influence on hospitalization expenses.Conclusion Patients’condition is the most important factor influencing hospitalization expenses,so a appropriate method of treatment can have remarkable therapeutic effects and reduce hospitalization expenses effectively.And a reasonable duration of hospital stay is also an effective way to reduce and control hospitalization expenses.

关 键 词：结构方程模型 消化道肿瘤 住院费用 影响因素 

分 类 号：R197.322[医药卫生—卫生事业管理]