恶性肿瘤患者住院费用及其影响因素研究  

A study on the hospitalization cost of malignant tumor patients and its influencing factors

作　　者：刘星媛 吴云涛 刘欣 陈曦[3] 吴丽娜 LIU Xing-yuan;WU Yun-tao;LIU Xin;CHEN Xi;WU Li-na(Statistics Division,Wuhan Municipal Health Information Center,Wuhan,Hubei 430014,China;不详)

机构地区：[1]武汉市卫生健康信息中心统计科,湖北武汉430014 [2]武汉儿童医院中西医结合科,湖北武汉4430015 [3]武汉市中心医院医学资讯科,湖北武汉4430014

出　　处：《现代预防医学》2022年第8期1449-1452,共4页Modern Preventive Medicine

基　　金：武汉市卫生健康科研基金资助《全口径统计分析平台项目建设》(WG20C08)。

摘　　要：目的 研究恶性肿瘤患者住院费用及影响因素。方法 采用描述性统计方法分析恶性肿瘤患者住院费用的一般特征;利用秩和检验比较不同住院费用的分布特征;应用通径分析方法分析住院费用的的直接影响因素和间接影响因素。结果 性别、年龄、医疗付款方式、是否手术、有无并发症、入院时情况和出院情况对次均住院费用的影响差异有统计学意义(P<0.05)。通径分析结果表明,实际住院天数和性别对住院费用只存在直接效应,直接通径系数为(P_(yly2)=0.641)和(P_(yly2)=-0.065);年龄、医疗付款方式、是否手术、有无并发症、入院时情况和出院情况对住院费用存在间接效应,间接通径系数分别为(r_(x2y)*P_(yly2)=-0.031)、(r_(x2y)*P_(yly2)=0.023)、(r_(x2y)*P_(yly2)=0.112)、(r_(x2y)*P_(yly2)=-0.046)、(r_(x2y)*P_(yly2)=-0.094)和(r_(x2y)*P_(yly2)=-0.049)。住院费用总效应的影响因素大小依次排序为实际住院天数(0.641)、是否手术(0.287)、入院时情况(-0.240)、出院情况(-0.125)、有无并发症(-0.117)、年龄(-0.080)、性别(-0.065)和医疗付款方式(0.059)。结论 住院天数是影响恶性肿瘤患者住院费用的最主要因素。应通过合理使用临床路径,开展临终关怀服务,切实减轻恶性肿瘤患者的经济负担。Objective To study the hospitalization expenses of patients with malignant tumor and its influencing factors.Methods Descriptive statistics was used to analyze the general characteristics of hospitalization costs of patients with malignant tumors. Rank sum test was used to compare the distribution characteristics of different hospitalization costs. The direct and indirect influencing factors of hospitalization costs were analyzed by means of path analysis. Results There were statistically significant differences in the impact of gender, age, medical payment method, surgery, presence or absence of complications, admission and discharge conditions on average hospitalization expenses(P<0.05). The path analysis results showed that the actual length of hospital stay and gender only had a direct effect on hospitalization costs, and the direct path coefficients were(P_(yly2)=0.641) and gender(P_(yly2)=-0.065);age, medical payment method, whether surgery, whether there were complications symptoms, conditions at admission and discharge had indirect effects on hospitalization costs, and the indirect path coefficients were(r_(x2y)*P_(yly2)=-0.031),(r_(x2y)*P_(yly2)=0.023),(r_(x2y)*P_(yly2)=0.112),(r_(x2y)*P_(yly2)=-0.046),(r_(x2y)*P_(yly2)=-0.094), and(r_(x2y)*P_(yly2)=-0.049). The magnitude of the factors influencing the total effect of hospitalization cost was in the order of actual days of hospitalization(0.641), whether surgery was performed(0.287), condition on admission(-0.240), discharge(-0.125),presence of complications(-0.117), age(-0.080), gender(-0.065), and medical payment method(0.059). Conclusion Hospitalization duration is the most important factor affecting hospitalization costs for patients with malignancy. The economic burden of malignant tumor patients should be effectively reduced through the rational use of clinical pathways and the development of end-of-life care services.

关 键 词：恶性肿瘤 住院费用 通径分析 影响因素 

分 类 号：R197.32[医药卫生—卫生事业管理]