基于结构方程模型的肾癌手术病人住院周期影响因素分析

Research on the Length-of-Hospital Stay of Radical Nephrectomy Based on Structural Equation Model

将患者因素、病理因素、手术因素和伴随因素四个方面作为潜变量来建立根治性肾切除术住院周期影响因素的结构方程模型。通过文献分析和专家访谈分别对四个潜变量选择合适的观测变量。在此基础上，对上海市某三甲医院243份根治性肾切除术患者病理数据进行实证分析，在建立的初始结构方程模型之上，分别进行一阶验证性因子分析和二阶因子分析，同时对模型进行了修正，得到的最后的拟合模型，通过了模型的检验。结果发现，患者因素和病理因素对住院周期有很强的解释力，其次是手术因素，最弱的是伴随因素。本研究为医院利用工业工程工程定量分析方法缩短住院周期提供了重要借鉴。

A structural equation model of length-of-hospital stay for radical nephrectomy was established from regarding patient attribute, pathological attribute, surgery attributes and adjoint attribute as latent variables. The major observed variables were analyzed and determined by using literature review and experts interviews. On this basis,243 radical nephrectomy patients data were extracted from a hospital in Shanghai and used to empirical analysis. By using the structural equation model to carry on confirmatory factor analysis, the two-order factor analysis and modifying model, the final fitting model was obtained and the final fitting model through the model test. It was found that the patient attribute and pathological attribute have a strong explanatory power to the length-of-hospital stay, and the second is the surgery attribute, the weakest is the adjoint attribute. The work presented provides significant reference for hospitals to shorten the length-of-hospital stay by utilizing quantitative methods of Industrial Engineering.