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目的对某三甲专科医院肺癌患者腔镜与开放手术住院费用进行对比分析,探讨腔镜手术在肺癌治疗中的应用特点。方法收集某三甲专科医院2013年-2015年所有肺癌手术患者的住院信息,按照患者手术方式不同分为腔镜手术和开放手术2组,使用SPSS 18.0建立数据库并进行统计分析,采用Wilcoxon秩和检验和卡方检验,比较2组患者的住院费用和诊疗信息,采用多元线性回归分析进行住院费用影响因素的统计。结果腔镜手术患者中位总费用为62 914.77元,比开放手术患者高2180.99元;其中腔镜手术的手术用一次性耗材费和手术费都高于开放手术组,但开放手术患者药费占总费用的32.61%,而腔镜手术患者仅为21.56%,绝对值降低了6673.90元,差异均有统计学意义。性别、年龄、是否本地、住院天数、是否输血、手术方式是住院总费用的影响因素。腔镜手术患者的中位住院日比开放手术患者的中位住院日短3天,其中术后中位住院日平均缩短2天,且差异有统计学意义。结论腔镜手术虽然手术用一次性耗材费和手术费较高,但腔镜手术能显著缩短住院日,降低药费、诊断类费和综合医疗服务类费,有利于提高医院的运转效率,具有良好的卫生经济学效益。
Objective To compare the cost of endoscopic and open surgery in patients with lung cancer in a tertiary specialized hospital and explore the application characteristics of endoscopic surgery in the treatment of lung cancer. Methods The hospitalization information of all lung cancer patients from 2013 to 2015 in a tertiary specialized hospital were collected and divided into two groups by endoscopic surgery and open surgery. The data were analyzed by SPSS 18.0 and analyzed by Wilcoxon rank sum test And chi-square test, hospitalization costs and treatment information were compared between two groups of patients, and multiple linear regression analysis was used to calculate the influencing factors of hospitalization expenses. Results The total cost of endoscopic surgery for patients was 62 914.77 yuan, 2180.99 yuan higher than the open surgery patients, including endoscopic surgery surgery disposable supplies costs and operating costs are higher than the open surgery group, but the open surgery patients accounted for The total cost of 32.61%, while the endoscopic surgery patients was only 21.56%, the absolute value of 6673.90 yuan lower, the differences were statistically significant. Sex, age, local or not, length of hospital stay, blood transfusion, and surgical modalities were all factors that affected the total cost of hospitalization. The median length of stay in patients undergoing endoscopic surgery was 3 days shorter than the median length of stay in patients undergoing open surgery, with a median postoperative length of stay of 2 days shorter on average, with statistically significant differences. Conclusions Although the one-time cost of surgical supplies and surgical fees for endoscopic surgery are high, endoscopic surgery can significantly reduce the length of stay, reduce the fees for medical treatment, diagnosis and comprehensive medical services, which is beneficial to improve the operating efficiency of the hospital. Good health economics benefits.