胃癌手术患者住院天数及住院总费用影响因素分析

Analysis of Influencing Factors on Length of Stay and Total Cost in Surgery Patients of Gastric Cancer

目的探讨胃癌手术患者住院天数及住院总费用的影响因素。方法通过电子病历系统检索筛选2015年1月1日-2019年12月31日,有手术标记且诊断为胃癌的患者,按照纳入标准及排除标准筛选774例作为研究对象,采用SPSS20.0软件对患者住院总费用及住院总天数的影响因素进行组间比较。结果胃癌手术患者术前平均住院4.9天;总住院天数平均19.8天;住院总费用平均54633.1元;住院总费用主要为药品费用、耗材类、诊断类、治疗类,合计占比82.5%。不同组间住院总费用比较中年龄、入院途径、手术方式、抢救、非计划再次手术、高血压、心脏病、糖尿病、输血、医疗付费方式、手术年份组间比较差异均有统计学意义,P<0.05;不同组间住院日比较中年龄、入院途径、高血压、心脏病、糖尿病、输血、医疗付费方式、手术年份差异有统计学意义,P<0.05。结论高龄、急诊入院、合并高血压、心脏病、糖尿病、输血、城镇居民或职工医疗保险或其他保险手术患者的住院时间及住院费用会相对增加;住院总费用及住院天数呈逐年上升趋势;腔镜手术增加患者住院总费用但对住院天数无影响;非计划再次手术增加患者住院总费用。

Objective To investigate the influencing factors of length of stay and total cost of hospitalization in patients undergoing radical gastrectomy for gastric cancer.Methods According to inclusion criteria and exclusion criteria,to selected patients with surgically marked gastric cancer from January 1,2015 to December 31,2019,and search and screen the subjects by electronic medical record system.SPSS20.0 software was used to compare the influencing factors of total hospitalization cost and total hospitalization days among groups.Results The average preoperative hospitalization of gastric cancer patients was 4.9 days,the average length of stay was 19.8 days,the average cost was 54,633.1 yuan.The total hospitalization expenses were mainly drug expenses,consumable materials,diagnosis expenses and treatment expenses,accounting for 82.5%.There were significant differences in the age,the way of admission,the way of operation,whether rescue,unscheduled reoperation,whether complicated hypertension,heart disease,diabetes,whether blood transfusion,the way of medical payment and the number of years between different groups(P<0.05).There were significant differences in hospital stay among different groups(P<0.05),including age,admission route,hypertension,heart disease,diabetes,medical payment,blood transfusion,and year.Conclusion Patients with advanced age,emergency admission,hypertension,heart disease,diabetes,blood transfusion,medical insurance for urban residents or workers,or other insurance operations will have a relatively increased length of stay and hospitalization costs.The total cost and the length of stay increased year by year,the total cost of laparoscopic surgery increased but had no effect on the length of stay,and the total cost of unplanned reoperation increased.