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目的通过分析某医院近三年肺癌住院患者费用构成及变化情况,探究影响其住院费用的关键因素,从而为费用控制策略的制定提供参考。方法从该院信息系统中抽取2014-2016年全部肺癌住院患者病案数据,应用趋势检验、Spearman秩相关检验、多重线性逐步回归等统计方法分析住院费用的变化趋势和影响因素。结果 2014-2016年该院纳入研究的3 364例肺癌患者以男性中老年为主,住院天数呈现正偏态分布,中位数为10天;三年间肺癌患者年平均住院日呈现逐年下降趋势;放疗人数呈现逐年下降趋势;住院总费用和在院期间药品费用具有高度相关性,且均呈逐年降低趋势,年降幅分别为6.84%、10.88%和13.67%、20.81%;住院天数、是否放疗、药占比、是否手术及是否有合并症为住院费用的影响因素。结论通过缩短平均住院日、控制药占比、落实按病种管理等途径可以有效降低肺癌患者住院费用,在保障医疗质量的同时减轻患者经济负担。
Objective To analyze the cost structure and changes of hospitalized patients with lung cancer in the past three years in a hospital and explore the key factors that affect the cost of hospitalization so as to provide reference for the formulation of cost control strategies. Methods All hospitalized patients with lung cancer from 2014 to 2016 were collected from the hospital information system. The trend of hospitalization expenses and its influencing factors were analyzed by trend test, Spearman rank correlation test and multiple linear stepwise regression. Results Among the 3 364 lung cancer patients included in the study, male patients were mainly middle-aged and elderly in 2014-2016. The median length of stay was 10 days. The annual average length of stay of patients with lung cancer showed a decreasing trend year by year. The total number of hospitalized patients was significantly lower than that of other hospitalized patients during the period of hospitalization, and all showed a year-on-year decrease of 6.84%, 10.88%, 13.67% and 20.81% respectively. The days of hospitalization, radiotherapy, Drugs accounted for, whether the surgery and whether there is comorbid factors for hospitalization costs. Conclusion By reducing the average length of stay, the proportion of controlled drugs, and the implementation of disease-based management can effectively reduce the cost of hospitalization of patients with lung cancer, while ensuring the quality of medical care while reducing the financial burden on patients.