四川省某三甲医院恶性肿瘤终末期患者住院费用影响因素分析  

Analysis on the Influencing Factors of the Hospitalization Costs of Patients with End-of-life Malignant Cancer in a Three A and Tertiary hospital in Sichuan Province

作　　者：张琪 魏丹 高玥珊 蒋婷婷 陈茜 Zhang Qi;Wei Dan;Gao Yueshan;Jiang Tingting;Chen Qian(不详;Department of Geriatrics Centre,West China Hospital,Sichuan University/West China School of Nursing,Sichuan University,Chengdu 610041,Sichuan Province,China)

机构地区：[1]四川大学华西医院老年医学中心/四川大学华西护理学院,四川省成都市610041 [2]四川大学华西国家老年疾病临床研究中心,四川省成都市610041 [3]护理学四川省重点实验室,四川省成都市610031

出　　处：《中国病案》2024年第8期43-49,共7页Chinese Medical Record

基　　金：四川省科技厅项目(24KJPX0155);四川省干部保健科研项目(川干研2024-117)。

摘　　要：目的探讨恶性肿瘤终末期患者住院费用的影响因素,为控制恶性肿瘤终末期患者医疗费用和研究安宁疗护卫生经济学价值提供数据参考。方法回顾性分析2018年1月1日-2022年12月31日在成都市某医院住院治疗2040例恶性肿瘤患者的基本情况、住院费用构成,采用描述性分析、单因素方差分析、多元线性回归等方法对住院费用及其影响因素进行统计分析。结果恶性肿瘤终末期患者住院天数中位数为16天,住院费用中位数为35009.82元,其中以西药费为主(45.61%)。多元线性回归分析提示住院天数、使用呼吸机、医保类型、使用抢救药物、血液透析、癌症种类、气管插管、输血、气管切开为恶性肿瘤终末期患者住院费用的主要影响因素(P<0.05)。结论恶性肿瘤终末期患者住院费用受多种因素影响,建议建立综合医院与安宁疗护机构双向转诊标准和服务流程,有效缩短平均住院日。Objective To explore the influencing factors of hospitalization costs of patients with end-of-life malignant cancer,and provide data reference for controlling the hospitalization costs of patients with end-of-life malignant cancer and researching the economic value of hospice care.Methods To analyze the basic situation and the composition of hospitalization costs of 2040 patients with malignant cancer who were hospitalized in a hospital in Chengdu city from January 1st,2018 to December 31st,2022 retrospectively,and conducted a statistically analysis of hospitalization costs and its influencing factors by using descriptive analysis,one-way ANOVA,and multivariate linear regression.Results The median length of stay in the hospital for patients with end-of-life malignant cancer was 16days,and the median hospitalization cost was 35,009.82 yuan,which was dominated by the cost of western medicines(45.61%).Multiple linear regression analysis suggested that the length of stay in the hospital,use of ventilator,type of medical insurance,use of resuscitation medications,hemodialysis,type of cancer,tracheal intubation,blood transfusion,and tracheotomy(P<0.05)were the main influences on the hospitalization cost of patients with end-of-life malignant cancers.Conclusions Hospitalization costs for patients with end of life malignant cancer were affected by a variety of factors,and it was recommended that standards and service processes for two-way referrals between general hospitals and hospice care institutions be established to effectively shorten the average length of stay.

关 键 词：恶性肿瘤 终末期 决策 住院费用 构成 

分 类 号：R197.3[医药卫生—卫生事业管理]