小肠肿瘤住院费用的路径归因分析

Factor Analysis on Hospitalization Expense of Small Intestine Cancer

目的:系统分析小肠部位恶性肿瘤患者住院费用的影响因素,明确费用的影响路径及其影响程度,为医院费用管理做参考依据,为减轻患者经济负担作参考。方法:回顾性搜集2010年1月—2014年12月小肠肿瘤住院患者数据,应用结构方程模型构建住院费用的主要影响因素。结果:年份、平均住院日、性别、是否手术和病理分型能直接影响住院次均费用,医保身份和疾病复杂程度通过住院天数间接影响次均费用。结论:精细化的费用管理需考虑病种费用的关键影响因素和路径。对于肿瘤专业,同一病种存在不同的病理分型等因素,而治疗方案往往需要个体化,未来的肿瘤专业病种付费将是一项系统工程。

Objective:To systematically analyze the impact of hospitalization expense for patients with malignant tumor at small intestine,define the influencing path of costs and its influencing degree,so as to provide references for hospital expenditure management and releasing the economic burden for patients.Methods:Retrospectively collected data of hospitalized patients with small intestinal tumor from January 2010 to December 2014,applied structural equation model to construct main influencing factors of hospitalization expenses.Results:Year,length of stay(LOS),gender,operation or not,pathological classification can directly affect the average per time hospitalization cost,healthcare status and disease complexity indirectly affect the expenses by LOS.Conclusion:Delicacy management of hospitalization expense should take the key influence factors and path attribution into consideration.For tumor specialty,the same disease with different pathological classification,therapeutic schedules diverge remarkably.The macro-reform of payment by diseases for tumor would be a systematic project.