274例绝经后子宫肌瘤患者住院费用分析

Analysis on the Hospitalization Costs of 274 Postmenopausal Patients with Hysteromyoma

目的 选取北京市某医院绝经后子宫肌瘤患者的住院数据,对其费用水平、费用结构和影响因素进行分析,为合理控费、减轻患者费用负担提供依据。方法 收录2019年6月15日-2022年12月31日的绝经后子宫肌瘤274住院病例,通过一般性描述和构成比分析住院费用水平和费用结构,采用单因素方差分析及多元线性回归统计方法分析该病种住院费用的影响因素。结果 患者平均住院天数6天,次均住院费用为14 077.34元,其中手术麻醉费用占比最高(30.82%),材料费用占比第2(23.94%),药品费用占比第3(14.89%),化验费用占比第4(10.07%),检查治疗费用占比第5(8.12%)。通过单因素方差分析和多元线性回归分析得出,住院天数、术中出血量、手术个数、手术方式等因素对住院费用有显著影响,住院天数越长、手术个数越多、术中出血量越多,总费用越高;宫腔镜手术的总费用明显低于腹腔镜、宫腹联合和开腹手术的总费用。结论 绝经后子宫肌瘤患者住院费用有所上升,住院天数缩短了(1.22±0.12)天,材料费、手术费、药费和检验费为主要费用构成。其中,住院天数、术中出血量、手术个数、手术方式是影响住院费用的主要因素,建议通过深化临床路径来规范医疗行为,优化费用结构,降低无效住院日,进一步减轻老年女性患者的费用负担。

Objectives To select hospitalization data of postmenopausal uterine fibroids patients from a certain hospital in Beijing,analyze their cost level,cost structure,and influencing factors,and provide a basis for reasonable cost control and reducing the patient's costs burden.Methods The study included hospitalized cases of postmenopausal uterine fibroids from June 15th,2019 to December 31st,2022.The level and structure of hospitalization costs were analyzed through general description and constituent ratio analysis.The influencing factors of hospitalization costs for this disease were analyzed using one-way ANOVA and multiple linear regression statistical methods.Results Among 274 patients,the average length of stay was 6 days,and the average hospitalization cost was 14077.34 yuan per visit.Among them,surgical anesthesia cost accounted for the highest proportion(30.82%),material cost accounted for the second(23.94%),drug cost accounted for the third(14.89%),laboratory cost accounted for the fourth(10.07%),and examination and treatment cost accounted for the fifth(8.12%).Through one-way ANOVA and multiple linear regression analysis,it was found that factors such as hospitalization days,intraoperative bleeding,number of surgeries,and surgical methods have a significant impact on hospitalization costs.The longer the hospitalization days,the more surgeries,and the more intraoperative bleeding,the higher the total cost;The total cost of hysteroscopic surgery was significantly lower than the total cost of laparoscopic,combined abdominal,and open surgery.Conclusions The hospitalization costs for postmenopausal patients with uterine fibroids had increased,with a reduction of 1.22±0.12 days in length.The main costs include material costs,surgical costs,medication costs,and testing costs.Among them,hospitalization days,intraoperative bleeding,number of surgeries,and surgical methods were the main factors that affected hospitalization costs.It was recommended to deepen clinical pathways to standardize medical behavior,optimize cost structure,reduce ineffective hospitalization days,and further reduce the costs burden on elderly female patients.