某三甲医院肝癌肝切除术单病种住院费用及相关影响因素分析

Single disease hospital cost of hepatectomy for hepatocellular carcinoma in a 3A hospital and its related factors analysis

目的通过对肝癌肝切除术住院费用、时间及相关影响因素的分析,为实现其单病种付费制提供依据。方法分析某大型医院肝癌肝切除术的住院费用、住院时间及临床资料,对其分布特点进行统计学描述,并应用单因素变量分析及多元线性回归模型,对临床特征与住院费用及住院时间的关系进行分析。结果住院时间是决定住院费用的关键因素;输血、术后并发症及Child-Pugh评分是影响住院费用的独立因素;此外,对住院时间有影响的变量包括术后并发症及手术方式。结论我国肝癌肝切除术患者的住院费用和住院时间有着各自的特点和不同的决定因素。

Objective To provide guidance for single disease payment on hepatectomy for hepatocellular carcinoma （HCC） by analysis of hospital costs, length of hospital stay （LOHS） and other related factors. Methods Hospital costs, LOHS and other relevant clinical data of HCC patients underwent hepatectomy in a large hospital were collected and analyzed. The distribution characteristics of the data were described statistically. Then the relationships among various clinical characteristics, hospital costs and LOHS were analyzed by using single-factor variable analysis and muhvariate linear regression model. Results LOHS was the key determinant of hospital costs. Blood transfusion, postoperative complications and Child-Pugh score were independent determinants of hospital costs. Additionally, predictors for pro- longed hospital stays included postoperative complication and surgical procedure. Conclusion Hospital costs and LOHS of hepatectomy for HCC have their own characteristics and different determining factors in China.