北京某肿瘤医院初治食管癌的住院费用及影响因素分析

Analysis of Impact Factors of Hospitalization Cost of Initial Treatment of Esophageal Cancer in A Cancer Hospital in Beijing

目的 分析医院初治的食管癌住院费用影响因素,为医疗费用控制、医疗资源配置、癌症防控政策制定提供决策参考。方法 回顾性分析北京某三甲肿瘤专科医院2015年1月1日-2019年12月31日食管癌初治患者的病案资料共计4485份,对研究指标进行描述性统计分析、单因素统计分析、逐步回归多因素分析。结果 共纳入食管癌患者4485例,平均住院费用为8.96万元。影响住院费用的独立影响因素包括:年龄(P=0.05)、收入情况(P=0.04)、付费方式(P<0.01)、治疗方式(P<0.01)、住院天数(P<0.01)等。肿瘤分期与治疗方式有明显相关性(P<0.01)。结论 食管癌住院费用影响因素众多、直接医疗负担较重,北京市综合医疗改革,对食管癌患者住院费用控制和结构调整有积极作用。我们既要规范诊疗,又要推行早诊早治,积极推行医疗改革,从而有效降低群众医疗负担、合理配置医疗资源。

Objectives The impact factors of hospitalization cost of the initial treatment of esophageal cancer patients in a large cancer hospital in China were analyzed to provide reference for healthcare decision-making, medical cost control, medical resource allocation and policy formulation in terms of cancer prevention and control. Methods Aretrospective analysis was performed on the medical records of 4485 patients with esophageal cancer initially treated in a Three A and Tertiary Cancer Hospital in Beijing from January 1st, 2015 to December 31st, 2019, and descriptive statistical analysis, univariate statistical analysis and step-to-regression multivariate analysis were performed. Results A total of 4485 patients with esophageal cancer were included in the research, with an average hospitalization cost of 89,600 yuan. The independent impact factors of hospitalization cost include: age(P=0.05), income population(P=0.04), reimbursement type(<0.05), treatment method(P<0.05) and length of inpatient stay(P<0.05).There was a significant correlation between tumor stage and treatment(P<0.01). Conclusions There were many factors influencing the hospitalization cost of esophageal cancer. The direct medical burden was heavy. The comprehensive medical reform in Beijing had a positive effect on the cost control and structural adjustment of hospitalization of patients with esophageal cancer, which suggested that we should not only standardize diagnosis and treatment, but also carry out early diagnosis and treatment, and actively carry out medical reform, so as to effectively reduce the medical burden of the patients and rationally allocate medical resources of medical institutions.