566例乳腺癌患者住院费用影响因素分析

Analysis of Hospitalization Costs and Influencing Factors in 566 Breast Cancer Patients

目的回顾性分析女性乳腺癌患者CHS-DRG分组效果及住院费用的影响因素,为完善付费制度和分析医疗费用构成提供参考。方法收集某院2020年1月1日-2021年12月31日566例乳腺癌患者住院信息,采用CV和RIV评价DRGs组住院费用分组结果,采用最优尺度回归分析筛选分析15项指标影响因素及影响程度。结果结合CHS-DRG分组结果,各组CV值均小于1,RIV值小,S-W检验呈偏态分布,中位数检验有显著差异;通过检验模型F=80.960,P=0.000,调整后的R^(2)为0.729。实际住院天数、是否乳腺病损切除术、是否乳腺改良根治术、是否单侧乳房根治性切除伴区域淋巴结切除术、是否化疗、入院次数、是否病危病重对住院费用影响显著。结论乳腺癌患者DRGs分组能充分反映各组费用差异,医院应充分利用DRGs付费优点,提升医务人员医疗技术和服务水平;结合住院费用特点,缩短住院天数、完善医保制度等措施以有效控制医疗费用增长。

Objectives The effect of CHS-DRG grouping and the influencing factors of hospitalization expenses in female breast cancer patients were retrospectively analyzed to provide reference for improving the payment system and analyzing medical expenses.Methods The hospitalization information of 566 breast cancer patients in a hospital from January 1st,2020 to December 31st,2021 was collected,and CV and RIV were used to evaluate the grouping results of hospitalization expenses in the DRGs group.The optimal scale regression analysis was used to screen and analyze the influencing factors and degree of influence of 15 indicators.Results Combined with the CHS-DRG grouping results,the CV value of each group was less than 1,the RIV value was small,S-W test shows skewed distribution,and the median test was significantly different;through the test model F=80.960,P=0.000,the adjusted R-squared was 0.729.The actual length of hospital stay,whether mastectomy,whether modified radical mastectomy,whether unilateral radical mastectomy with regional lymphadenectomy,whether chemotherapy,number of hospital admissions,and whether or not critically ill had a significant impact on hospitalization costs.Conclusions The DRGs grouping of breast cancer patients could fully reflect the cost difference of each group.Hospitals should make full use of the advantages of DRGs payment to improve the medical technology and service level of medical staff.Combined with the characteristics of hospitalization expenses,measures such as shortening the length of hospitalization and improving the medical insurance system could effectively control the growth of medical expenses.