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目的探讨食管癌患者住院费用的影响因素,为合理控制医疗费用的过快增长提供依据。方法收集某省级肿瘤专科医院2006-2012年7年间共计8 068例食管癌患者的病历,运用通径分析方法探讨食管癌患者住院费用的影响因素。结果住院天数的直接效应为0.873,是影响住院费用最主要的直接因素;职业和性别直接影响住院费用,直接通径系数为-0.042和-0.009;医疗付款方式间接影响住院费用,效应值为0.084;住院科室、转归情况、手术与否、合并症数量、肿瘤部位、住院年份等因素既可直接影响住院费用,又通过住院天数间接影响住院费用,总效应分别为0.416、-0.395、0.322、0.110、-0.060和-0.038。结论有关部门需采取综合措施,规范临床路径,合理控制药价,提高医疗服务质量,有效控制住院费用过快增长。
Objective To explore the influencing factors of hospitalization expenses in patients with esophageal cancer and provide the basis for the reasonable control of the excessive growth of medical expenses. Methods A total of 8 068 cases of esophageal cancer were collected from a provincial oncology hospital from 2006 to 2012 for 7 years. Pathological analysis was used to explore the influencing factors of hospitalization cost in esophageal cancer patients. Results The direct effect of hospitalization days was 0.873, which was the most direct and direct factor affecting hospitalization expenses. Occupation and sex directly influenced the hospitalization expenses. The direct path coefficient was -0.042 and -0.009. The medical payment method indirectly affected the hospitalization expenses with an effect value of 0.084 ; Hospital departments, the outcome of the situation, surgery or not, the number of complications, tumor location, length of hospitalization and other factors both directly affect the cost of hospitalization, but also indirectly affect the cost of hospitalization by hospitalization days, the total effect of 0.416, -0.395,0.322, 0.110, -0.060 and -0.038. Conclusion The relevant departments need to take comprehensive measures, standardize clinical pathways, control drug prices rationally, improve the quality of medical services, and effectively control the excessive growth of hospitalization expenses.