2018—2020年武汉市肺癌患者住院费用及其影响因素分析  

Influencing factors of hospitalization costs for lung cancer patientsin Wuhan in 2018-2020

作　　者：陈曦[1] 刘晓雪[2] 兰勇兵 宇传华[2] 刘星媛 叶平[1] CHEN Xi;LIU Xiaoxue;LAN Yongbing;YU Chuanhua;LIU Xingyuan;YE Ping(Wuhan Central Hospital,Wuhan,Hubei 430014,China;Wuhan University,Wuhan Hubei 430071,China;Wuhan Health Information Center,Wuhan,Hubei 430022,China)

机构地区：[1]武汉市中心医院,湖北武汉430014 [2]武汉大学,湖北武汉430071 [3]武汉市卫生健康信息中心,湖北武汉430022

出　　处：《公共卫生与预防医学》2023年第4期63-66,共4页Journal of Public Health and Preventive Medicine

基　　金：武汉市卫生健康委科研项目(WG20D08);武汉市卫生健康委科研项目(WX21B30)。

摘　　要：目的分析肺癌患者住院费用及其影响因素,为控制肺癌患者住院费用提供依据。方法采集武汉市2018—2020年肺癌住院病案首页数据,采用非参数检验对住院费用进行单因素分析。根据住院总费用的上四分位数将肺癌患者分为两组:高费用组和正常费用组,将P<0.05的变量纳入logistic回归模型进行多因素分析。结果分析结果表明,年龄是住院费用的一个独立影响因素,与70岁以上的肺癌患者相比,<50岁组和50~<60岁组肺癌患者发生高费用的风险高,OR值分别为1.247和1.215,但60~<70岁组的差异无统计学意义(OR=1.070,P=0.295);医院级别是住院费用的一个独立影响因素,与远城区医院相比,区属医院、市属医院、省属医院和四大家医院发生高费用的OR值分别为2.838,3.728,7.815和11.646;医院类型是住院费用的一个独立影响因素,综合医院比专科医院发生高费用的风险高(OR=4.726);住院天数是住院费用的一个独立影响因素,住院天数越长,发生高费用的风险随之上升。治疗方式是住院费用的一个独立影响因素,比非手术治疗方式相比,手术切除术、放疗和介入发生高费用OR值分别为556.129,18.156,5.212。结论不同年龄组、医院级别、医院类型、住院天数和治疗方式是肺癌患者住院费用的独立影响因素,应规范肺癌患者诊疗方案,重点规范治疗方式,同时充分考虑医院级别和类型等因素,从而降低肺癌患者住院费用。Objective To summary the hospitalization costs of lung cancer patients,and analyze the influence factors in these patients,and provide basis for controlling hospitalization costs of lung cancer patients.Methods The hospitalization costs data of hospitalized lung cancer cases in Wuhan from 2018 to 2020 were collected from medical records.Nonparametric test was used to analysis the data for single factor analysis.The patients were divided into two groups according on the upper quartile value of hospitalization cost,that is high-cost group(the cost≥the upper quartile value)and normal cost group(the cost<the upper quartile value),then the influence factors were analyzed by logistic regression model.Results The logistic regression model showed that age is an independent influencing factor,compared with the higher age group(years≥70),the OR is 1.247,1.215 for years<50 group and 50 to<60 years group respectively,but there is no statistics difference for 60 to<70 years group(OR=1.070,P=0.295);The hospital level is an independent influencing factors,compared with the hospital in suburban,the OR is 2.838,3.728,7.815 and 11.646 for district hospital,municipal hospitals,provincial hospital and“four major hospitals in Hubei”respectively.The hospital type is an independent influencing factors,compared with specialized hospital,the OR is 4.726 for general hospital.The hospitalization days is the independent influencing factors,more hospitalization days has high cost.The treatment mode is the independent influencing factors,compared with non-operative treatment,the OR is 556.129,18.156 and 5.212 for surgical model,radio therapy model and interventional model respectively.Conclusion The age,hospital level,hospital type,hospitalization days and treatment mode are the independent influencing factors of hospitalization costs.To reduce the hospitalization cost of lung cancer patients,we should standardize the diagnosis of lung cancer patients,and focus on standardizing the treatment mode,also considering other influencing fac

关 键 词：肺癌 住院费用 治疗方式 

分 类 号：R181[医药卫生—流行病学]