原发性肝癌患者住院费用影响因素研究

Study on Hospitalization Expenses and Influencing Factors of Patients with Primary Liver Cancer

目的了解原发性肝癌患者住院费用构成及影响因素,为合理控制住院费用提供参考。方法提取山东省某三甲医院2018年1月1日至2020年12月31日1860例原发性肝癌患者住院病案首页信息,采用描述性分析、非参数检验、相关分析及分位数回归等方法对住院费用构成及影响因素进行统计分析。结果2018年至2020年原发性肝癌患者住院费用分别为33416.34元、32876.47元和32545.64元,药占比分别为28.48%、26.65%和26.03%,耗占比分别为28.91%、30.01%和25.81%。三年平均耗材费与平均住院费用相关性较强(r=0.906)。非参数检验显示住院费用的影响因素包括:离院方式、付费方式、出院情况、是否手术、住院次数和住院天数等(P<0.05)。分位数回归分析显示是否手术、住院次数和住院天数等因素在P_(10)、M、P_(90)分位点上对住院费用的影响均具有统计学意义(P<0.05),离院方式、付费方式、出院情况等在不同分位数点上对住院费用也产生了影响。结论是否手术、住院次数和住院天数是住院费用的重要影响因素,建议合理缩短住院天数以降低住院费用。

Objectives To understand the composition and influencing factors of hospitalization expenses of patients with primary liver cancer,and provide reference for reasonable control of the hospitalization expenses.Methods The front pages information of 1860 hospitalized patients with primary liver cancer from January 1st,2018 to December 31st,2020 in a Three A and Tertiary Hospital of Shandong Province was extracted.Descriptive analysis,nonparametric test,correlation analysis and quantile regression were used to analyze the composition of hospitalization expenses and influencing factors.Results From 2018 to 2020,the hospitalization expenses of primary liver cancer patients were¥33416.34,¥32876.47and¥32545.64,respectively.The drug proportion was 28.48%,26.65%and 26.03%,and the medical consumables proportion was 28.91%,30.01%and 25.81%,respectively.There was a strong correlation between the three-year average consumables expenses and the average hospitalization expenses(r=0.906).The nonparametric test showed that the influencing factors of hospitalization expenses included:discharge mode,payment method,discharge situation,whether to have surgery,the number of hospitalizations and the length of hospital stay(P<0.05).Quantile regression showed that factors such as whether to have surgery,the number of hospitalizations and the length of hospital stay had statistically significant effects on the hospitalization expenses at the P_(10),M,and P_(90) quantiles(P<0.05).The discharge mode,payment method,and the discharge situation also had an impact on the hospitalization expenses at different quantiles.Conclusions The drug proportion and the medical consumables proportion decreased.Whether to have surgery,the number of hospitalizations and the length of hospital stay were important factors affecting the hospitalization expenses.It was recommended to shorten the length of hospital stay to reduce the hospitalization expenses.