2012-2018年贵州省某三甲医院肺癌患者住院费用影响因素分析  

Analysis on influencing factors of hospitalization expenses of lung cancer patients in a tertiary hospital in Guizhou Province

作　　者：廖贵曲 黄娟娟 张慧岩 张湘燕[2] LIAO Gui-qu;HUANG Juan-juan;ZHANG Hui-yan;ZHANG Xiang-yan(Medical College of Guizhou University,Guiyang 550025,China;Department of Respiratory Medicine,Guizhou Provincial People’s Hospital,Guiyang 550002,China)

机构地区：[1]贵州大学医学院,贵州贵阳550025 [2]贵州省人民医院呼吸内科,贵州贵阳550002

出　　处：《社区医学杂志》2021年第14期885-890,共6页Journal Of Community Medicine

基　　金：国家科技支撑计划(2013BAI09B09)。

摘　　要：目的通过对贵州省某三甲医院肺癌患者住院费用的影响因素进行探究,为控制医疗费用的增长,减轻患者疾病负担,巩固脱贫攻坚成果提供实践依据。方法选取贵州省某三甲医院2012-01-01-2018-12-31出院的6776例肺癌患者,对其住院费用进行统计分析,利用多元逐步回归模型和通径分析方法研究其住院费用影响因素。结果肺癌患者的例均住院天数为14.52d,住院费用为29149.85元。通径分析结果显示,住院费用的主要影响因素为药品费(总效应值为0.825)、住院天数(总效应值为0.732)、是否手术(总效应值为0.150)、出院时间(总效应值为0.145)、完成临床路径(总效应值为-0.122)、医保支付比例(总效应值为0.102)、入院情况(总效应值为0.100)、转归情况(总效应值为-0.066)和付费方式(总效应值为0.072)。其中是否手术、付费方式、入院及转归情况不仅直接影响住院费用,还通过住院天数和药品费间接影响住院费用。结论药品费和住院天数是肺癌患者住院费用的最主要影响因素,控制住院费用的增长,关键是在合理使用药物的基础上,有效缩短住院天数。Objective To explore the influencing factors of hospitalization expenses of patients with lung cancer in a tertiary hospital in Guizhou Province,in order to provide practical basis on controlling the increase of the medical expenses,reducing the burden of disease on patients,and consolidating achievements in poverty alleviation.Methods A total of 6776 patients with lung cancer who were discharged from a tertiary hospital in Guizhou Province from January 1,2012 to December 31,2018 were selected.The hospitalization expense was analyzed statistically,and the influencing factors of hospitalization expense were studied by multiple stepwise regression model and path analysis method.Results The average hospitalization day was 14.52 days and the average hospitalization expense was 29149.85 yuan.Path analysis showed that the main factors affecting the hospitalization expenses of lung cancer patients included drug costs,hospitalization days,surgery,discharge time,implementation of clinical pathway,proportion of medical insurance payment,disease condition at admission and patient outcome,the total effect value were 0.825,0.732,0.150,0.145,-0.122,0.102,0.100 and-0.066,respectively.Surgery,payment method,disease condition at admission and patient outcome not only have direct effects,but also indirectly affect hospitalization expenses through the hospitalization days and the drug costs.Conclusions Drug expenses and hospitalization days are the most important factors affecting the hospitalization expenses of patients with lung cancer.The key to controlling the increase of hospitalization expenses of lung cancer patient is to rationally control drug prescriptions and effectively shorten the hospitalization stay.

关 键 词：肺癌患者 住院费用 疾病负担 通径分析 

分 类 号：R197[医药卫生—卫生事业管理]