北京某医院呼吸科肺癌住院费用影响因素研究  

Analysis of Inpatient Cost of Lung Cancer Patients in Respiratory Department of a Hospital in Beijing

作　　者：冯志红[1] 李欣[2] 黄昊[1] 徐瑾[1] 黄海霞[2] 王涛[3] Feng Zhihong;Li Xin;Huang Hao;Xu Jin;Huang Haixia;Wang Tao(Xuanwu Hospital of Capital Medical University,Beijing 100053,China;不详)

机构地区：[1]首都医科大学宣武医院,北京市100053 [2]首都医科大学,北京市100069 [3]首都医科大学附属北京朝阳医院,北京市100020

出　　处：《中国病案》2023年第8期75-78,共4页Chinese Medical Record

摘　　要：目的探究北京某三甲医院呼吸科肺癌住院费用影响因素,为管理和控制肺癌患者住院费用提供线索。方法从病案首页系统抽取2017年12月19日-2022年12月16日呼吸科肺癌患者,共287例。采用描述性分析、单因素分析和多重线性回归方法,分析肺癌患者住院费用影响因素。结果纳入研究的患者住院费用为偏态分布(z=0.106,P<0.001),中位数和四分位间距为23075.16(17104.75,31223.88)元。单因素分析,是否进入重症监护室(t=-2.1,P=0.037)、住院天数(t=-8.888,P<0.001)、其他诊断个数(F=14.505,P<0.001)、继发恶性肿瘤数量(F=18.36,P<0.001)组间差异有统计学意义。多重线性回归分析,F=80.523,P<0.001,R2=0.461,肺癌住院费用影响因素包括住院天数、继发恶性肿瘤部位数量、其他诊断个数。结论住院天数越长、继发恶性肿瘤数量越多、其他诊断(合并症)个数越多住院费用越高,疾病越复杂和严重程度越高花费越大。通过有效控制合并症,并合理调整治疗策略,将住院时间控制在15天内,提高检测水平,提早发现转移情况等措施,可以降低住院费用。Objectives To explore the influencing factors of lung cancer inpatient expenses in respiratory department of a Three A and Tertiary Comprehensive Hospital in Beijing,and provide clues for the management and control of lung cancer inpatient expenses.Methods A total of 287 patients with lung cancer in respiratory department from December 19th,2017 to December 16th,2022 were selected from the home page of medical record system.Descriptive analysis,univariate analysis and multiple linear regression were used to analyze the influencing factors of hospitalization costs of lung cancer patients.Results The hospitalization cost of the included patients was skewed(z=0.106,P<0.001),and the median and interquartile distance was 23075.16(17104.75,31223.88)yuan.By univariate analysis,there were significant differences between the groups in whether they were admitted to the ICU(t=-2.1,P=0.037),length of stay(t=-8.888,P<0.001),number of other diagnoses(F=14.505,P<0.001),and number of secondary malignant tumors(F=18.36,P<0.001).Multiple linear regression analysis showed that F=80.523,P<0.001,R2=0.461 and the influencing factors of lung cancer hospitalization costs included length of stay in hospital,comorbidity and sites of secondary tumor involvement.Conclusions The longer the length of stay,the more secondary malignancies,comorbidities the higher the cost of hospitalization,the more complex and severe the disease.Hospitalization costs could be reduced by controlling complications and reasonably adjusting treatment strategies to control the duration of hospitalization within 15 days,and by improving detection level to detect metastasis in advance,move the threshold forward,and reduce hospitalization costs as much as possible.

关 键 词：肺癌 住院费用 其他诊断 继发性肿瘤 

分 类 号：R197.3[医药卫生—卫生事业管理] R734.2[医药卫生—公共卫生与预防医学]