肺癌患者住院费用构成及影响因素分析

Analysis of Inpatient Costs and Influencing Factors for Lung Cancer Patients

目的:了解肺癌患者住院费用构成及主要影响因素,为减轻患者经济负担及合理控制住院费用提供相关科学依据。方法:选取成都市某三甲医院2017年1月1日至2018年12月31日出院且主要诊断为肺癌的全部住院患者(17961例)的病案数据资料,采用描述性统计方法分析住院费用的构成,运用多元线性回归拟合通径模型分析肺癌住院患者住院费用的影响因素。结果:肺癌患者住院总费用最低93.0元,最高472822.6元,平均住院费用18475.5元,中位住院费用9928.4元。住院费用成构中,前4位依次为西药费、材料费、检查费和治疗费,分别占全部住院费用的23.33%、21.94%、16.94%和14.35%,四者之和总占比为76.56%。西药费、材料费、检查费和治疗费的通径系数分别为0.477、0.267、0.126和0.069。是否手术、是否放疗和住院天数也是影响肺癌患者住院费用的主要因素,通径系数分别为0.674、0.264和0.057。结论:西药费、材料费、检查费和治疗费是肺癌患者住院费用的主要构成,是否手术、是否放疗和住院天数是住院费用的主要影响因素。

Objective:To understand the composition and main influencing factors of inpatient costs in lung cancer patients,and provide basis for reducing patients’financial burden and reasonably controlling inpatient costs.Methods:Data of 17,961 lung cancer inpatients discharged from a level A tertiary hospital from January 1,2017 to December 31,2018 were selected.The composition of inpatient costs was analyzed by descriptive statistics,and influencing factors of inpatient costs in lung cancer patients were analyzed by multivariate linear regression fitting path model.Results:The lowest total inpatient costs in lung cancer patients was 93.0 yuan,while the highest was 472,822.6 yuan,with an average of 18,475.5 yuan and a median of 9,928.4 yuan.The top four inpatient costs were for western medicines,materials,check-ups and treatments,accounting for 23.33%,21.94%,16.94%and 14.35%of the total,respectively.The sum of the four was 76.56%.Path coefficients of inpatient costs in western medicines,materials,check-ups and treatments were 0.477,0.267,0.126 and 0.069,respectively.Surgery,radiotherapy and length of stay were also main factors affecting inpatient costs in lung cancer patients,with path coefficients of 0.674,0.264 and 0.057,respectively.Conclusion:Costs in western medicines,materials,check-ups and treatments are main components of inpatient costs in lung cancer patients.Surgery,radiotherapy and length of stay are main influencing factors of inpatient costs.