海南省某三甲医院乳腺癌患者住院费用影响因素分析

Analysis on hospitalization expenses and its influencing factors of breast cancer patients in a tertiary hospital in Hainan Province

目的了解乳腺癌患者住院费用情况并分析其影响因素,为降低乳腺癌患者医疗费用负担和制定合理的医疗保险制度提供依据。方法收集海南省某三甲医院2020年1月1日至2020年12月31日收治的1279例乳腺癌患者的住院费用构成情况,采用描述性分析、秩和检验和多元线性回归分析乳腺癌患者住院费用结构及其影响因素。结果乳腺癌患者住院费用构成中药品费占比最大(44.34%),诊疗费、材料费、手术费、床位费占比分别为14.49%、4.21%、2.76%和2.22%,其他费用合计31.97%;在医保统筹支付额度中,城镇职工患者医保统筹支付额度(8903.00元)高于城乡居民(7871.00元);单因素分析显示住院天数和治疗方式对患者住院费用有影响(P<0.05);多元线性回归分析显示住院天数(b′=0.607)和治疗方式(b′=0.252)是影响住院费用的主要因素(P<0.001)。结论应提高全社会对乳腺癌的防治意识,合理控制住院天数和药占比降低住院费用,调整医保待遇水平来减轻患者负担。

Objective To investigate the inpatient cost of breast cancer patients and analyze its influencing factors,so as to provide basis for reducing the medical cost burden of breast cancer patients and establishing reasonable medical insurance system.Methods The inpatient cost information of 1279 patients with breast cancer in a tertiary hospital in Hainan Province in 2020 was collected.Descriptive analysis,rank sum test and multiple linear regression were used to analyze the hospitalization cost structure of breast cancer patients and its influencing factors.Results Pharmaceutical expenses accounted for the largest proportion(44.34%)in the structure of hospitalization expenses,treatment expenses,material expenses,surgery expenses,and bed expenses accounted for 14.49%,4.21%,2.76%,and 2.22%respectively,and other expenses totaled 31.97%.In the amount of medical insurance pooling payment,the amount of medical insurance pooling payment for urban worker patients(8903.00 yuan)was higher than that for urban and rural residents(7871.00 yuan).Univariate analysis showed that length of stay and treatment mode had influence on hospitalization cost.Multiple linear regression analysis showed that the length of stay and treatment mode were the main factors affecting hospitalization costs,and their standardized regression coefficients were 0.607 and 0.252,respectively.Conclusion It is necessary to improve the awareness of the prevention and treatment of breast cancer in the whole society,rationally control hospitalization days and drug proportion to reduce hospitalization expenses,and adjust the level of medical insurance treatment to reduce the burden of patients.