2012年-2021年河南省某公立医院食管恶性肿瘤患者住院费用分析

Analysis of Hospitalization Costs of Patients with Esophageal Cancer in Large Public Hospitals in Henan Province from 2012 to 2021

目的了解河南省某公立医院食管恶性肿瘤住院费用构成及影响因素,为合理控制医疗费用提供依据。方法收集2012年1月1日-2021年12月31日某大型公立医院住院病案首页主诊断编码为C15.900的食管癌住院患者,有效病例9722例。对医疗总费用呈偏态分布的定量资料进行Lg对数转换后,进行描述性分析,采用单因素线性回归、多重线性回归进行影响因素分析。结果患者例均医疗总费用为15038.81元,平均住院天数为14.16天;2012年-2021年患者医疗人均总费用年均增长率为2.51%。治疗转归情况(β=-0.101~0.101)、是否手术(β=0.332)、住院天数(β=0.547)、性别(β=-0.017)等对医疗总费用的影响具有统计学意义(P<0.05)。结论药费和耗材费用占比最高,合理控制药品和耗材使用;加强食管癌防治宣传,改善个人生活方式;优化诊疗方式,降低住院天数,提升医保报销比例,是降低患者医疗负担的措施。

Objectives This study aims to understand the composition and influencing factors of hospitalization expenses for esophageal cancer in a large public hospital in Henan Province,and provide a basis for reasonable control of medical expenses.Methods From January 1,2012 to December 31,2021,a total of 9722 effective cases of inpatients with esophageal cancer whose main diagnosis code was C15.900 on the front page of inpatient medical records in a large public hospital were collected.Descriptive analysis was carried out after Lg logarithmic transformation of quantitative data with skewed distribution of total medical expenses.Single factor linear regression and multiple linear regression were used to analyze the influencing factors.Results The average medical cost of the patients was 15038.81 yuan,and the average length of hospitalization was 14.16 days.From 2012 to 2021,the average annual growth rate of total medical expenses per patient was 2.51%.The effects of treatment outcome(β=-0.101~0.101),operation or not(β=0.332),length of stay(β=0.547)and gender(β=-0.017)on total medical expenses were statistically significant(P<0.05).Conclusions Drugs and consumables accounted for the highest proportion and the use of drugs and consumables should be controlled reasonably.It is suggested to strengthen the publicity of prevention and treatment of esophageal cancer and improve personal lifestyle.Optimizing diagnosis and treatment methods,reducing the number of days in hospital,and increasing the proportion of medical insurance reimbursement are measures to reduce the medical burden of patients.