基于参数与半参数回归模型的肺肿瘤患者住院费用影响因素分析  

Analysis of Factors Influencing Hospital Expenses for Lung Cancer Patients Using Parametric and Semiparametric Regression Models

作　　者：张治飞 黄磊[2] 刘秋硕 朱小凤[1] 李天俊 卢婷 Zhang Zhifei;Huang Lei;Liu Qiushuo;Zhu Xiaofeng;Li Tianjun;Lu Ting(Medical Record Management Center,Suining Central Hospital,Suining 629000,Sichuan Province,China)

机构地区：[1]遂宁市中心医院病案管理中心,四川省遂宁市629000 [2]西南交通大学数学学院,四川省成都市611756 [3]四川省卫生健康信息中心,四川省成都市610041 [4]四川大学华西天府医院医保办公室,四川省成都市61004

出　　处：《中国病案》2025年第1期46-49,共4页Chinese Medical Record

基　　金：四川省自然科学基金(2022NSFSC1850);病案首页质控管理效果评价体系的构建探索(2022yg101)。

摘　　要：目的分析肺肿瘤住院患者医疗费用的影响因素,为控制肿瘤患者医疗费用,减轻经济负担提供依据。方法收集整理成都市某三甲医院2020年1月5日-2020年12月31日收治出院的1335例首次接受手术治疗的肺肿瘤住院患者信息,结合单因素与多因素的参数与半参数回归模型,探索分析影响肺肿瘤患者住院费用的影响因素。结果单因素统计分析结果显示,40岁以上患者占82.1%,不同年龄组间患者的住院费用存在显著差异;女性患者占比高于男性,且不同性别间住院费用也具有显著差异;此外,90%以上患者确诊为恶性肿瘤,88.2%的患者接受了经胸腔镜的手术,92%的患者术后切口愈合良好。据多因素回归模型结果,半参数模型拟合效果优于参数模型,同时当住院天数大于10天时,住院天数与费用之间存在显著的波动非线性关系。综合参数与半参数模型结果,年龄、医保类型、是否恶性、是否胸腔镜、手术级别、愈合情况以及住院天数的回归系数通过显著性检验(P<0.05)。结论年龄、医保类型、是否恶性、是否胸腔镜、手术级别、愈合情况以及住院天数是该院肺肿瘤患者住院费用的影响因子,其中住院天数具有非线性的特征,综合所得影响因子,医疗机构应提高医疗质量,缩短住院天数,扩散疾病早筛义诊人群范围,增加早诊断早治疗机会,以减轻患者的经济负担。Objectives This study aims to analyze the influencing factors of medical expenses for inpatients with lung cancer and to provide evidence for scientific control of medical expenses and reduction of economic burden.Methods Data from 1,335 inpatients with lung tumors who underwent surgery for the first time,admitted and discharged from a Grade III hospital in Chengdu between January 5,2020,and December 31,2020,were collected and analyzed.Combined with univariate and multi-factor parametric and semi-parametric regression models,the influencing factors on hospitalization costs of lung tumor patients were explored and analyzed.Results Univariate statistical analysis showed that patients over 40 years old accounted for 82.1%,and there were significant differences in hospitalization costs among different age groups.The proportion of female patients was higher than that of male patients,and the hospitalization cost was significantly different between different genders.In addition,more than 90%of patients were diagnosed with malignant tumors,88.2%of patients underwent thoracoscopic surgery,and 92%of patients had good postoperative incision healing.According to the results of the multi-factor regression model,the fitting effect of the semi-parametric model was better than that of the parametric model.At the same time,when the number of days in hospital was greater than 10,there was a significant fluctuating nonlinear relationship between the number of days in hospital and the cost.Based on the results of parametric and semi-parametric models,the regression coefficients of age,medical insurance type,malignancy,thoracoscopy,surgical grade,healing status and length of hospitalization passed the significance test(P<0.05).Conclusions Age,type of medical insurance,malignancy,thoracoscopy,level of surgery,healing and length of stay are the influencing factors for hospitalization costs of patients with lung tumors in this paper,among which the length of stay is non-linear.Based on the influencing factors obtained in this paper,med

关 键 词：肺肿瘤 住院费用 影响因素 参数与半参数 回归模型 

分 类 号：R734.2[医药卫生—肿瘤]