2013—2022年中国北方医院宫颈癌患者住院费用结构变动度和灰色关联法分析  

Hospitalization costs for cervical cancer patients in three tertiary hospitals in northern China,2013-2022:degree of structural variation and gray relational analysis

作　　者：王梦婷 阴建[1,2] 朱奕潼 左婷婷 朱博 游嘉 杨雯 王红 乔友林 王宇萍[1] WANG Mengting;YIN Jian;ZHU Yitong;ZUO Tingting;ZHU Bo;YOU Jia;YANG Wen;WANG Hong;QIAO Youlin;WANG Yuping(School of Population Medicine and Public Health,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100005,China;Department of Epidemiology,Cancer Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,National Cancer Center/National Clinical Research Center for Cancer,Beijing 100021,China;Liaoning Cancer Prevention Office,Liaoning Cancer Hospital,Cancer Hospital of China Medical University,Shenyang 110042,China;The Seventh Medical Center,Chinese PLA General Hospital,Beijing 100700,China;Office of the Cancer Center,The Affiliated Cancer Hospital of Zhengzhou University,Henan Cancer Hospital,Zhengzhou 450008,China)

机构地区：[1]中国医学科学院北京协和医学院群医学及公共卫生学院,北京100005 [2]国家癌症中心国家肿瘤临床医学研究中心中国医学科学院北京协和医学院肿瘤医院流行病学研究室,北京100021 [3]中国医科大学肿瘤医院辽宁省肿瘤医院辽宁省肿瘤防治办公室,沈阳110042 [4]中国人民解放军总医院第七医学中心,北京100700 [5]郑州大学附属肿瘤医院,河南省肿瘤医院癌症中心办公室,郑州450008

出　　处：《中国公共卫生》2024年第6期718-723,共6页Chinese Journal of Public Health

基　　金：中国医学科学院医学与健康科技创新工程(2021-I2M-1-045);比尔及梅琳达·盖茨基金会(INV-031449)。

摘　　要：目的了解宫颈癌患者住院费用结构变动情况,并探讨费用变动的原因。方法采用结构变动度分析法和灰色关联分析法分析2013—2022年中国北方3所三甲医院的5654例宫颈癌患者住院数据,结构变动度分析法用于描述住院费用构成的总体特征和动态变化趋势,灰色关联分析法用于评估住院费用与各单项费用之间的关联程度。结果2013—2022年,5654例宫颈癌患者的总住院费用呈上升趋势,住院费用结构变动度较小,年均结构变动度为18.60%,诊断费和药费是影响费用变动的两个显著因素。其中,2013—2022年诊断费和药费结构变动值呈正向变动,对住院费用结构变动贡献前3位费用项目分别为其他费用(35.87%)、诊断费(32.09%)以及药费(16.44%),累计结构贡献率为84.40%。诊断费占比呈明显上升,对结构变动贡献较大,表明诊断费是住院费用的主要构成。药费近年来占比下降,但仍然是影响费用变动的重要因素。灰色关联分析显示,2013—2022年其他费用(0.855)与住院费用关联度最大,其次是诊断费(0.824)、药费(0.781)。结论诊断费、药费及其他费用结构贡献率较高,与住院费用关联度最大,是影响住院费用变动的主要因素。综合医疗服务费和治疗费的结构贡献率相对较低,且与住院费用的关联度也较低,对住院费用的结构和变动趋势影响较小。Objective To understand the structural variation in hospitalization costs for patients with cervical cancer and to investigate the reasons for these variations.Methods Using the degree of structural variation(DSV)analysis and grey relational analysis methods,we analyzed the hospitalization data of 5654 cervical cancer patients from three class A tertiary hospitals in northern China from 2013 to 2022.The DSV was used to describe the overall characteristics and dynamic trends of the hospitalization cost composition,while gray relational analysis assessed the correlation between hospitalization costs and individual cost items.Results During this period,the average individual total cost of hospitalization for all patients studied showed an upward trend with a low overall DSV and an average annual DSV of 18.60%.Diagnostic fees and drug costs were two significant factors influencing cost changes.In particular,the structural variation values of diagnostic fees and drug costs showed positive changes during this period.The top three cost items contributing to the change in hospital cost structure were other fees(contribution rate:35.87%),diagnostic fees(32.09%),and drug costs(16.44%),with a cumulative structural contribution rate of 84.40%.The proportion of diagnostic fees has increased significantly,contributing to the structural variation,indicating that diagnostic fees are a major component of hospitalization costs.Although the proportion of drug costs has decreased in recent years,it remains an important factor influencing cost changes.Gray relation analysis showed that from 2013 to 2022,other fees had the highest correlation with hospitalization costs(correlation coefficient:0.855),followed by diagnostic fees(0.824)and drug costs(0.781).Conclusion For the hospitalization costs of cervical cancer patients from tertiary hospitals in northern China,diagnostic fees,drug costs,and other fees contribute significantly to the cost structure and have the highest correlation with hospitalization costs,which are significant fac

关 键 词：宫颈癌 住院费用 结构变动度 灰色关联分析 

分 类 号：R197.3[医药卫生—卫生事业管理]