结直肠癌患者住院费用构成及其影响因素分析  

Analysis of the Composition of Hospitalization Expenses of Colorectal Cancer Patients and Its Influencing Factors

作　　者：吴艳倩 樊志敏[1] WU Yanqian;FAN zhimin(Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Nanjing,210000,China)

机构地区：[1]南京市中医院,江苏南京210000

出　　处：《中国社会医学杂志》2022年第5期592-596,共5页Chinese Journal of Social Medicine

基　　金：江苏省第十五批“六大人才高峰”创新人才团队项目(TD-SWYY-015)。

摘　　要：目的 分析结直肠癌患者住院费用构成及其影响因素,为控制结直肠癌患者住院费用的增长以及降低结直肠癌患者的疾病经济负担提供参考。方法 以江苏省某三级中医院2015年1月—2019年12月主要诊断为结直肠癌的6 967份有效病案为研究对象,运用描述性分析、单因素分析、多元逐步回归分析法探讨结直肠癌住院费用的影响因素,利用灰色关联法分析费用变动的主要影响因素。结果 6 967例结直肠癌患者次均住院费用为20 586.11元,住院费用中位数为10 976.64元;次均住院天数为10.06天,中位数为7天。影响住院费用的因素包括:年龄、住院科室、出院年份、是否手术、手术并发症、是否化疗、是否放疗以及是否中医药治疗。结直肠癌患者住院费用变动因素前三位依次是西药费、检验费和材料费。结论 西药费、检验费和材料费是影响结直肠癌患者住院费用的关键因素,应加强对西药费、检验费和材料费使用的监管,进一步规范临床路径、优化医保支付方式等来合理控制结直肠癌患者住院费用的过快增长,减轻患者的经济负担。Objective To investigate the combination of hospitalization cost for patients with colorectal cancer and its Influencing factors, so as to provide a reference about controlling the hospitalization cost increment of patients with colorectal cancer and reducing their financial burden.Methods Medical records of 6 967 patients with colorectal cancer from January 2015 to December 2019 were extracted to make an exploration of the hospitalization cost for patients with colorectal cancer by means of description analysis, single factor analysis and multiple stepwise regression analysis, and to figure the main influential factor of changes in fees using grey relational method.Results The average hospitalization cost for patients with colorectal cancer was 20 586.11 yuan and the median was 10 976.64 yuan.The average duration of hospitalization was 10.06 days, and the day’s median was 7.Factors influencing hospitalization expenses included age, hospitalization department, year of discharge, surgery, surgical complications, chemo-therapy, radiotherapy, and Chinese medicine treatment.The top three influencing factors for hospitalization cost for patients with colorectal cancer were western medicine fee, inspection fee and material fee.Conclusion Western medicine fee, inspection fee and material fee are the key factors affecting the hospitalization expenses of patients with colorectal cancer.It is necessary to strengthen the supervision of the use of western medicine fees, inspection fees and material fees, to further standardize clinical pathways and optimize medical insurance payment methods so as to control the rapid increase in hospital expenses and reduce the patients’ financial burden.

关 键 词：结直肠肿瘤 住院费用 影响因素 灰色关联度 

分 类 号：R735.35[医药卫生—肿瘤] R735.37[医药卫生—临床医学]