胃肠外科13111例患者住院总费用及其影响因素分析

Analysis of the Influencing Factors and the Cost of 13111 Patients from Gastrointestinal Surgery

目的:了解胃肠外科患者住院总费用及其影响因素,为有效控制住院费用、提高医疗服务质量提供有效依据。方法:选取天津市某三甲医院胃肠外科2017年1月1日—2021年12月31日的出院患者作为研究对象,排除住院总费用小于10元的出院患者,共计纳入13111例患者进行研究,运用多元线性回归方程模型对总费用的影响因素进行建模分析。结果:年龄、婚姻状态、户籍与患者住院总费用的相关性,差异有统计学意义(χ^(2)=2.69、F=52.33、χ^(2)=9.41,P<0.05);入院状态、入院途径、是否转科、是否当日再入院、是否半个月内再入院和是否31 d内再入院、住院天数、疾病诊断数和手术操作数与患者住院总费用有关,多元线性回归结果显示,入院途径、是否转科、住院天数、疾病诊断数、手术操作数、当日再入院、半个月内再入院和31 d内再入院在5%的显著性水平下,差异有统计学意义(t=5.54、23.96、79.81、12.44、46.85、3.22、2.85、2.28,P<0.05),并且这些影响因素均与住院总费用呈正相关关系。调整R^(2)为0.55,显示年龄、民族、疾病诊断数等指标能解释住院总费用变化的55%。结论:入院途径、是否转科、住院天数、疾病诊断数、手术操作数、当日再入院、半个月内再入院和31 d内再入院是影响住院总费用的主要因素。

Objective:To know the cost components and influencing factors of patients from gastrointestinal surgery,so as to provide an effective basis for effectively controlling hospitalization costs and improve the quality of medical services.Methods:13111 discharged patients admitted to the gastrointestinal surgery of the hospital from January 1,2017 to December 31,2021 were selected as the study subjects.And the influencing factors of the total cost were modeled with multiple linear regression equation.Results:Age,marital status and registration were related to the total medical costs,the differences were statistically significant(χ^(2)=2.69,F=52.33,χ^(2)=9.41;P<0.05).The admission status,admission route,whether or not to transfer,whether or not readmission on that day,whether or not readmission within half a month,whether or not readmission within 31 days,hospital stay,number of disease diagnoses and the number of operation were related to the total medical costs.Multiple regression equation showed that there was statistically significant when the route of admission,whether or not to transfer,number of days in the hospital,number of disease diagnoses,number of surgical operations,same-day readmissions,readmissions within half a month,and readmissions within 31 days were at a significant level of 5%(t=5.54,23.96,79.81,12.44,46.85,3.22,2.85,2.28;P<0.05).And those factors had a positive effect on the total medical costs.The adjusted R^(2) was 0.55,showing that age,ethnicity,and number of disease diagnoses could explain 55%of the variation in total hospitalization costs.Conclusion:Route of admission,whether or not to transfer,number of days in the hospital,number of disease diagnoses,number of surgical operations,same-day readmissions,readmissions within half a month,and readmissions within 31 days mainly influence the total cost of hospitalization.