基于临床路径的慢性鼻窦炎手术患者住院费用影响因素分析

Analysis of influencing factors of hospitalization expenses in patients with chronic rhinosinusitis surgery based on clinical pathway

目的探讨慢性鼻窦炎手术患者住院费用构成和影响因素,为医疗机构病种费用控制和医保制定病种支付标准提供参考依据。方法收集2018年1月1日至2020年12月31日福建省某三甲医院收治的慢性鼻窦炎手术临床路径患者病案资料,采用描述性分析、多元线性回归对住院费用结构及影响因素进行统计分析。结果从住院费用结构看,手术费、耗材费、药费位居前三位;多元线性回归结果显示,麻醉方式是影响住院费用的首要因素,其次是鼻窦手术数量和部位,再次是住院天数、合并症、年龄和年份。结论通过选择合适的麻醉方式、多部门联合控费、完善临床路径、合理缩短住院天数等措施,可以有效降低慢性鼻窦炎手术患者的住院费用。

Objective To explore the composition and influencing factors of hospitalization expenses in patients with chronic rhinosinusitis surgery,and to provide reference for the control of disease expenses in medical institutions and the formulation of disease payment standards by medical insurance.Methods The medical records of patients with chronic rhinosinusitis admitted to a tertiary hospital in Fujian Province from January 1,2018 to December 31,2020 were collected,and descriptive analysis and multiple linear regression analysis were used to analyze the structure of hospitalization expenses and its influencing factors.Results In terms of the structure of hospitalization expenses,operation cost,consumables cost,and drug cost ranked the top three;the multiple linear regression results showed that anesthesia method was the primary factor affecting hospitalization cost,followed by the number and location of sinus surgery,and then the length of hospitalization,complications,age and year.Conclusion The hospitalization expenses of patients with chronic rhinosinusitis can be effectively reduced by selecting appropriate anesthesia methods,jointly controlling expenses by multiple departments,improving clinical pathways,and reasonably shortening the hospital stay.