2274例胃恶性肿瘤患者住院费用影响因素分析  

Analysis on the Influencing Factors of Hospitalization Expenses of 2274 Cases of Gastric Malignant Tumor Patients

作　　者：刘星媛 吴云涛 陈曦[3] 吴丽娜 裴圣广[3] Liu Xingyuan;Wu Yuntao;Chen Xi;Wu Lina;Pei Shengguang(Department of Statistics,Wuhan Health Information Center,Wuhan 430014,Hubei Province,China;不详)

机构地区：[1]武汉市卫生健康信息中心统计科,湖北省武汉市430014 [2]武汉儿童医院中西医结合科,湖北省武汉市430015 [3]武汉市中心医院医学资讯科,湖北省武汉市430014

出　　处：《中国病案》2022年第12期43-47,共5页Chinese Medical Record

基　　金：武汉市卫生健康科研基金资助(WG20C08)。

摘　　要：目的 分析胃恶性肿瘤患者住院总费用的影响因素,为减轻患者经济负担、合理控制住院总费用过高过速增长提供参考依据。方法 研究对象为2017年1月1日-2020年12月31日某市市属医院胃恶性肿瘤出院患者,包括12家三级医院和1家二级医院。按照国际疾病分类标准提取主要诊断为C16的住院病案首页数据,2274例病案最终纳入研究。提取实际住院天数、住院总费用、性别、年龄等内容,采用通径分析方法计算住院总费用的直接和间接影响因素。结果 对住院总费用直接影响因素最大的为实际住院天数,标准化回归系数=0.443,P<0.001;对住院总费用既有直接效应,又通过影响实际住院天数产生间接效应的因素中,是否手术的效应最大,为0.700,其次为实际住院天数、有无并发症、转归情况、年龄和入院时情况等,效应分别为0.443、0.073、-0.211、-0.009、-0.003。结论 对住院总费用影响因素最大的为是否手术,其次为实际住院天数。下一步应通过加强健康宣教,强化高危群体筛查,规范医院诊疗服务行为,提升医疗服务效率等措施有效降低胃恶性肿瘤患者住院总费用。Objectives To analyze the influencing factors of hospitalization expenses for patients with gastric malignant tumors, and provide references for reducing the economic burden of patients and reasonably controlling the excessive growth of hospitalization expenses. Methods The study subjects were discharged patients with gastric cancer from a municipal hospital in a city from January 1st, 2017 to December 31st, 2020, including 12 tertiary hospitals and 1 secondary hospital. According to the International Classification of Diseases(ICD) criteria, the front page data of inpatient medical records with the main diagnosis of C16 were extracted, and 2274 medical records were finally included in the study. The actual hospitalization days, total hospitalization expenses, gender, age and other contents were extracted, and the direct and indirect influencing factors of total hospitalization expenses were calculated by path analysis method. Results The biggest direct influence factor on the total hospitalization cost was the actual length of stay(standardized regression coefficient=0.443, P<0.001);of the factors that had a direct effect on the total hospitalization cost and an indirect effect through the actual length of stay, whether there was surgery The effect was the largest at 0.700, followed by the actual length of hospital stay, presence or absence of complications, outcome, age, and admission status. The effects were 0.443, 0.073,-0.211,-0.009,-0.003,respectively. Conclusions The biggest influencing factor on total hospitalization cost was whether to have surgery,followed by the actual length of hospital stay. In the next step, measures such as strengthening health education,strengthening the screening of high-risk groups, standardizing the behavior of hospital diagnosis and treatment services, and improving the efficiency of medical services should be taken to effectively reduce the total hospitalization cost of patients with gastric cancer.

关 键 词：胃恶性肿瘤 住院总费用 影响因素 通径分析 

分 类 号：R735[医药卫生—肿瘤] R197.32[医药卫生—临床医学]