基于分位数回归模型的结直肠癌手术患者住院费用影响因素分析

Analysis of Influencing Factors of Hospitalization Expenses in Patients with Colorectal Cancer Surgery Based on Quantile Regression Model

目的 分析结直肠癌手术患者住院费用的影响因素,为降低患者疾病负担提供参考。方法 收集北京地区2018年1月至2019年12月共10273例结直肠癌手术患者的住院相关信息,采用分位数回归模型,以住院费用的不同分位数为基准,划分为低、中、高三组分位费用组,描述解释相关变量对住院费用的影响。结果 住院年份、机构类型、年龄、住院天数及术后并发症对三个分位组的住院费用均有正向影响;使用中医药类治疗手段在三个住院费用分位组均呈现负向影响;医疗付款方式在中分位费用组呈现负向影响,手术方式则在低分位费用组呈现负向影响,而在中、高分位费用组为正向影响。结论 结直肠癌高危人群需定期体检,早筛早诊至关重要,从减少费用角度,建议临床医生应结合患者病情及经济情况,合理选择手术方式,并鼓励患者在住院期间接受中医药类治疗手段,合理安排检查检验,减少住院天数,以降低结直肠癌手术患者的住院费用。

Objective To analyze the influencing factors of hospitalization cost of colorectal cancer surgery patients,and to provide the references for reducing the burden of disease for the patients. Methods The information of a total of 10273 patients with colorectal cancer surgery in Beijing area from January 2018 to December 2019 was collected, and the quantile regression model was used. cost group, describing the effect of explanatory variables on hospitalization costs.Results The hospitalization year, institution type, age, length of hospital stay and postoperative complications all had a positive impact on the hospitalization expenses in the three quantile groups;the use of traditional Chinese medicine treatment methods showed a negative impact in the three quantile groups of hospitalization expenses. Medical payment method has a negative effect in the middle quantile cost group, while the surgical method has a negative effect in the low quantile cost group, while it has a positive effect in the middle and high quantile cost groups. Conclusion The high-risk group of colorectal cancer needs Regular physical examination, early screening and early diagnosis are very important.From the perspective of cost reduction, it is recommended that clinicians should choose the surgical method reasonably according to the patient’s condition and economic situation, and encourage patients to receive traditional Chinese medicine during hospitalization. Reducing hospital days to lower hospital costs for colorectal cancer surgery patients.