山西省2003—2012年胃癌患者住院费用影响因素分析

Hospitalization costs among 3151 gastric cancer patients in Shanxi province,2003 to 2012

目的探讨山西省胃癌患者住院费用的影响因素,为政府合理分配卫生资源、完善医疗保障制度以及卫生经济学评价提供依据。方法对山西省长治地区三级甲等综合医院和平医院2003—2012年3 151例胃癌患者的住院费用进行统计描述,并采用多元线性逐步回归模型分析住院费用的影响因素。结果 2003—2012年3 151例胃癌患者的平均住院天数中位数为16 d,人均住院费用为15 888.97元,日均住院费用为911.37元,且呈逐年上升趋势;住院费用构成中,药品费所占比例最大(36.59%),其次是手术费所占比例(15.85%);影响住院费用的主要因素依次为:是否手术、住院天数、药占比、付费方式、有无合并症、治疗结果和职业类型(均P<0.05)。结论胃癌患者的住院费用相对较高,应进一步完善医疗保障制度等措施以最大限度的降低胃癌患者的住院费用。

Objective To analyze influencing factors of hospitalization cost among gastric cancer patients and to provide evidences for rational allocation of health resources and the improvement of the medical security system. Methods Data on hospitalization cost for 3 151 gastric cancer inpatients in a third-level hospital in Shanxi province from 2003 to 2012 were extracted and analyzed with multivariate regression analysis. Results For the patients during the period, the hospitalization cost showed an increasing trend, with a median hospitalization days of 16,the average hospitalization cost per patient of 15 888.97 yuan（ RMB ）, and an average daily hospitalization cost per patient of 911.37 yuan. Drug expense accounted for 36. 59 % of total hospitalization costs, followed by the cost of operation （ 15.85 % ）. The main significant influencing factors for the hospitalization cost among the patients were surgery, days of hospitalization, the ratio of drug cost, complications, status of medical security, treatment outcome, and occupation of the patient（ all P 〈 0. 001 ）. Conclusion Hospitalizaion cost of gastric cancer patients was at a high level in Shanxi province during 2003 to 2012, suggesting medical security system should be improved to reduce the cost.