东南大学某附属医院结直肠肿瘤手术费用变化及影响因素

Treatment Cost Trends and Influencing Factors of Colorectal Tumor Surgery in An Affiliated Hospital of Southeast University

目的 探讨不同结直肠肿瘤手术患者费用差异,及其影响因素分析。方法 采用回顾性研究方法,选取2018年1月1日至2020年12月31日收治的结直肠恶性肿瘤手术患者3560例,分析2018年、2019年和2020年治疗费用,以及不同临床资料患者治疗费用差异,采用多元线性回归分析其影响因素。结果2020年度治疗费用为(8.21±0.92)万元,明显低于2018年和2019年(P<0.05);腹腔镜下手术、有转科、并发症患者治疗费用分别为(8.89±0.79)万元、(8.84±0.83)万元和(8.95±0.75)万元,明显高于开腹手术、无转科、无并发症患者(P<0.05);年龄>60岁患者治疗费用为(9.08±0.80)万元,明显高于其他年龄段(P<0.05);病理分期Ⅲ患者治疗费用为(9.07±0.82)万元,明显高于Ⅰ和Ⅱ期患者(P<0.05);肿瘤部位位于结肠患者治疗费用为(8.98±0.69)万元,明显高于直乙交界和直肠患者(P<0.05);住院日期>14天患者治疗费用为(9.02±0.80)万元,明显高于住院日期≤7天和8~14天患者(P<0.05);多元线性回归分析结果显示:年度、年龄、病理分期、手术方式、住院日期、转科及并发症是结直肠肿瘤手术患者治疗费用的影响因素(P<0.05)。结论 结直肠肿瘤手术患者治疗费用呈逐年下降趋势,其受患者年龄、病理分期、手术方式、住院日期等多种因素的影响,年龄大、选择腹腔镜手术、有转科、并发症、住院时间长、病理分期级别高的患者,其治疗费用相对较高。

Objective To explore the cost difference of patients with different colorectal tumor surgery and its influencing factors. Methods A retrospective study method were used, a total of 3560 patients with colorectal malignancy who underwent surgery from January 1, 2018 to December 31, 2020 were selected, the treatment costs were analyzed in 2018, 2019 and 2020, as well as the differences in treatment costs of patients with different clinical data, the influencing factors were analyzed by multiple linear regression. Results The annual treatment cost in 2020was(8.21±0.920) ten thousand yuan, which was significantly lower than that in 2018 and 2019(P<0.05);The treatment costs of patients with laparoscopic surgery, transfer and complications were(8.89±0.79) ten thousand yuan,(8.84±0.83) ten thousand yuan and(8.95±0.75) ten thousand yuan, respectively, which were significantly higher than those of patients with open surgery, no transfer and no complications(P<0.05);The treatment cost of patients aged > 60 years was(9.08±0.80) ten thousand yuan, which was significantly higher than those other age groups(P<0.05);The treatment cost of the patients with pathological stage Ⅲ was(9.07±0.82) ten thousand yuan, which was significantly higher than that of the patients with Ⅰ stage and Ⅱstage(P<0.05);The treatment cost of colon patients was(8.98±0.69) ten thousand yuan, which was significantly higher than that of rectum sigmoid colon junctionpatients and rectum patients(P<0.05);The treatment cost of patients with date of hospitalization > 14d was(9.02±0.80) ten thousand yuan, which was significantly higher than that of patients with ≤7 days and 8-14 days(P<0.05);Multiple linear regression analysis showed that year, age,pathological stage, surgical method, hospitalization date, department transfer and complications were the influencing factors of the treatment cost of colorectal cancer patients undergoing surgery(P<0.05). Conclusion The treatment cost of patients with colorectal cancer surgery is decreasing year by year. Due to the influence of patient age, pathological staging, surgical mode, hospitalization date and other factors, patients with old age,laparoscopic surgery, transfer, complications, long hospitalization time and high pathological staging level are relatively high.