儿童急性髓系白血病住院费用及影响因素

Hospitalization Expenses and Influencing Factors of Children with Acute Myeloid Leukemia

目的分析儿童急性髓系白血病患者住院费用水平及构成情况,探讨住院费用的影响因素。方法收集云南省某三甲医院2014年1月1日-2019年12月31日入院的275例急性髓系白血病患儿的病例资料,对住院费用进行统计描述,对其影响因素进行单因素分析和多元线性回归分析。结果共纳入病例266例,平均年龄为7.643.99岁。次均住院费用为15302.33元,在2014年-2019年间有上升的趋势,定基比分别为80.87%、109.32%、162.98%、131.15%和189.32%。住院费用构成中,药费、化验费、输血费居前3位,占比分别为44.13%、18.28%和16.09%。单因素与多因素分析结果显示住院天数、住院次数、医疗付款方式与住院费用之间的差异有统计学意义。结论药费和化验费相对较高;住院次数、住院天数、医疗付款方式是影响住院费用的主要因素,适当降低药费、减少化验次数和控制无效住院天数,能有效减轻家庭和社会的经济负担。

Objectives To analyze the level and composition of hospitalization expenses of children with acute myeloid leukemia,and explore the influencing factors of hospitalization expenses.Methods Case data of 275 children with acute myeloid leukemia in a Three A and Tertiary Hospital of Yunnan Province admitted from January 1st,2014 to December 31st,2017 were collected,and the composition of hospitalization expenses was statistically described.Univariate analysis and multiple linear regression analysis were performed on the influencing factors of hospitalization expenses.Results A total of 266 cases were included in this study,the average age was 7.64±3.99 years old,the average annual hospitalization expense was 15302.33 yuan.Hospitalization expenses showed a rising trend from 2014 to 2019,with a fixed base ratio of 80.87%,109.32%,162.98%,131.15%and 189.32%,respectively.Among the hospitalization expenses,drug expenses,laboratory expenses and blood transfusion expenses ranked the top three,accounting for 44.13%,18.28%and 16.09%,respectively.Results of univariate and multivariate analyses showed that statistically significant differences existed in length of stay,number of hospitalizations,payment method of medical treatment.Conclusions The cost of drugs and laboratory tests were relatively high in the cost of hospitalization.Hospitalization frequency,length of stay and payment method were the main factors that affect hospitalization cost.Appropriate reduction of medicine and laboratory expenses and the number of invalid days in hospital could effectively lighten the economic burden of family and society.