河南省某三甲医院乳腺癌手术患者住院费用影响因素分析

Influential factors of hospitalization costs in patients with breast cancer surgery at a tertiary hospital in Henan Province

目的:探讨河南省乳腺癌手术患者住院费用的影响因素,为制定合理的医疗费用控制措施提供依据。方法:收集河南省某三级甲等医院2013年7月到2016年6月出院的4 177例乳腺癌手术患者住院病例,采用描述性分析,秩和检验和多元线性回归等统计方法,分析住院费用构成及其影响因素。结果:乳腺癌手术患者住院费用主要构成是药费、诊断检查费,分别占总费用的26.93%、24.18%。单因素分析显示不同住院时间、肿瘤分期、手术方式、有无并发症、麻醉方式等特征的住院费用差异有统计学意义;多重线性回归分析显示,住院时间(β=0.106)、肿瘤分期(stageⅡ、stageⅢ、stageⅣ,β分别为0.057、0.070、0.059)、手术方式(β=0.019)及有并发症(β=0.039)是住院费用的影响因素(P<0.05)。结论:合理控制住院时间,及早筛查并发症,优化选择手术方式,可有效降低住院费用、减轻患者经济负担。

Aim： To investigate the influencing factors of hospitalization costs in patients with breast cancer surgery in Henan Province and provide the basis for making reasonable medical cost control measures. Methods： A total of 4 177 cases of breast cancer discharged from a tertiary hospitals in Henan Province from July 2013 to June 2016 were collected,descriptive analysis,rank sum test and multivariate linear regression were used to analyze the proportion of hospitalization costs and its influencing factors. Results： The major components of hospitalization expenses for the patients were drug charges and diagnosis examination fees,accounting for 26. 93% and 24. 18% of the total fees,respectively. The univariate analysis of hospitalization costs showed that there were significant differences in hospitalization costs between different hospitalization time,tumor staging,surgical methods,presence or absence of complications and anesthesia methods. Multivariate linear regression analysis showed that hospitalization costs were influenced by hospitalization time（ β = 0. 106）,tumor staging（ β =0. 057,0. 070,0. 059 for stage Ⅱ,Ⅲ,Ⅳ）,operative methods（ β = 0. 019）,presence of complications（ β = 0. 039）. Conclusion： Reasonable control of hospitalization time,early screening of complications,and optimizing the selection of surgical methods,can effectively reduce hospitalization costs and reduce the financial burden on patients.