河南某医院2013-2023年恶性肿瘤患者医保住院费用构成及影响因素分析  

Analysis on the composition and influencing factors of medical insurance hospitalization expenses for malignant tumor patients in a hospital of Henan from 2013 to 2023

作　　者：刘学才[1] 吴恺[2] 李璐[1] 吴文典 LIU Xuecai;WU Kai;LI Lu;WU Wendian(Medical Insurance Office,the First Affiliated Hospital of Zhengzhou University,ZhengZhou 450002,China;Department of Thoracic Surgery,the First Affiliated Hospital of Zhengzhou University,ZhengZhou 450002,China)

机构地区：[1]郑州大学第一附属医院医保办,河南郑州450052 [2]郑州大学第一附属医院胸外科,河南郑州450052

出　　处：《肿瘤基础与临床》2024年第5期555-559,共5页journal of basic and clinical oncology

摘　　要：目的分析郑州大学第一附属医院2013-2023年恶性肿瘤患者医保住院费用构成及影响因素,为减轻恶性肿瘤患者住院经济负担提出建议。方法选取2013年1月至2023年12月郑州大学第一附属医院收治的63280例恶性肿瘤患者医保住院病历,采用描述性分析、单因素分析和回归分析等方法分析恶性肿瘤患者医保住院费用构成及影响因素。结果恶性肿瘤患者次均住院费用逐年上升,药品费和治疗费是住院费用的主要构成部分。影响恶性肿瘤患者医保住院费用的主要因素是住院天数,两者呈正相关(r=0.591,P=0.006)。单因素分析恶性肿瘤分类、年龄、手术情况、输血情况、医保付费方式、疗效等对恶性肿瘤患者医保住院费用均有影响(F=9.436,P<0.001;F=85.666,P<0.001;t=3.193,P=0.001;t=12.228,P<0.001;F=82.825,P<0.001;F=21.287,P<0.001)。逐步多元线性回归分析结果显示,影响恶性肿瘤患者医保住院费用的因素从大到小依次为住院天数、是否输血、是否手术、疗效、恶性肿瘤分类、医保付费方式(OR=6.190,P=0.002;OR=5.818,P=0.006;OR=5.557,P=0.013;OR=5.436,P=0.011;OR=4.721,P=0.009;OR=4.509,P=0.002)。结论恶性肿瘤患者医疗费用上涨趋势不可避免,但通过强化医务人员医保意识,规范诊疗方案,建立更完善的医保付费标准,能够有效缩短住院时间,进而减少患者住院费用。Objective To analyze the composition and influencing factors of medical insurance hospitalization expenses for malignant tumor patients in the First Affiliated Hospital of Zhengzhou University from 2013 to 2023,and to reduce the economic burden of malignant tumor patients in hospital.Methods The 63280 patients with malignant tumor admitted to the First Affiliated Hospital of Zhengzhou University from Jan 2013 to Dec 2023 were retrospectively collected,descriptive analysis,single factor analysis and regression analysis were used to analyze the composition and influencing factors of medical insurance hospitalization expenses for patients with malignant tumors.Results The average hospitalization cost of malignant tumor patients increases year by year,and the cost of drugs and treatment is the main component of the hospitalization cost.The number of days in hospital was the main factor affecting the hospitalization cost of patients with malignant tumor,and the two were positively correlated(r=0.591,P=0.006).Univariate analysis showed that malignant tumor classification,age,operation,blood transfusion,medical insurance payment method and curative effect had an impact on the medical insurance hospitalization costs of patients with malignant tumors(F=9.436,P<0.001;F=85.666,P<0.001;t=3.193,P=0.001;t=12.228,P<0.001;F=82.825,P<0.001;F=21.287,P<0.001).And the results of stepwise multiple linear regression analysis showed that the factors affecting the hospitalization cost of patients with malignant tumor were,from the largest to the smallest,the length of hospitalization,blood transfusion,operation,curative effect,malignant tumor classification,medical insurance payment method(OR=6.190,P=0.002;OR=5.818,P=0.006;OR=5.557,P=0.013;OR=5.436,P=0.011;OR=4.721,P=0.009;OR=4.509,P=0.002).Conclusion The rising trend of medical expenses for patients with malignant tumors is inevitable,but by strengthening the awareness of medical insurance among medical staff,standardizing diagnostic and treatment plans,and establishing more comprehens

关 键 词：恶性肿瘤患者 医保住院费用 影响因素 

分 类 号：R730[医药卫生—肿瘤]