|本期目录/Table of Contents|

[1]曾军杰,赵妍,唐现策,等.胃癌患者住院费用影响因素的通径分析[J].慢性病学杂志,2016,(01):25-28.
　ZENG Jun-jie *,ZHAO Yan,TANG Xian-ce,et al.An analysis of the influencing factors of hospitalization expense of gastric cancer patients[J].,2016,(01):25-28.
点击复制

胃癌患者住院费用影响因素的通径分析(PDF)

《慢性病学杂志》[ISSN:1674-8166/CN:11-5900/R]

卷:
期数:
2016年01期
页码:
25-28
栏目:
论著
出版日期:
2016-02-15

文章信息/Info

Title:
An analysis of the influencing factors of hospitalization expense of gastric cancer patients
作者:
曾军杰1; 赵妍2; 唐现策2; 赵二江2
1.河南省医学会，郑州450003；2.郑州大学附属肿瘤医院，郑州 450001
Author(s):
ZENG Jun-jie * ; ZHAO Yan; TANG Xian-ce; ZHAO Er-jiang
*HenanMedicalAssociation,Zhengzhou, Henan450003,China Correspondingauthor:ZENGJun-jie,E-mail:zengjunjie1979@163.com
关键词:
胃肿瘤; 住院费用; 影响因素; 通径分析
Keywords:
Gastric cancer;  Hospitalization costs;  Influence factors;  Path analysis
分类号:
R735.3
DOI:
-
摘要:
目的 探讨影响胃癌患者住院费用的主要因素。方法 收集某肿瘤专科医院2009-2014年5年间 7 386例胃癌患者的病案信息，采用逐步回归分析法以住院费用、住院天数为内生变量，拟合通径分析模 型，筛选影响住院费用的直接效应和通过住院天数影响住院费用的间接效应。结果 手术与否是影响住院 费用的最主要因素；住院天数、转归情况、住院年份、伴随病、性别、年龄和职业直接影响住院费用；出 院主诊断和医付方式间接影响住院费用；转归情况、手术与否、伴随病、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。手术与否、住院天数、转归情况影响住院费用总效应分别为 0.604、0.585、-0.387。结论 要降低住院费用，需要多部门共同努力，加强监督管理，合理治疗，合理 用药，规范临床路径，优化治疗检查流程，完善多层次社会健康保障体系。
Abstract:
Objective To explore the potential influencing factors affecting hospitalization expenses of pa-tients with gastric cancer. Methods A total of7 386 valid medical records of patients with gastric can-cer in a tumor hospital between 2009 and 2014 were studied. Stepwise regression was performed using the hospitalization expense and hospitalization days as the endogenous variables. The direct and indirect effects of the hospitalization expenses were screened by fitting the data with the path analysis model. Re-sults Whether surgery is performed was the most influential factor which affects the hospitalization ex-pense. Hospitalization days, outcomes, years, accompanying diseases, genders, ages and occupations di-rectly affected the cost. The main diagnosis and medical payment influenced hospitalization expenses indi-rectly. Vesting conditions, surgery or not, co-morbidities, the year of hospitalization influenced the cost both directly and indirectly through influencing hospitalization days. The total effect of surgery or not, days of hospitalization, and the outcomes were 0.604, 0.585 and -0.387, respectively. Conclusions To reduce the cost of hospitalization, the following approaches should be used: to make joint efforts of various departments, to strengthen supervision and management, reasonable treatment, rational use of drugs, the clinical path specification, optimization of treatment review process, to improve the health-care security system.

参考文献/References:

[1] Youn JC, Youn YH, Kim TI. Factors affecting longterm clini? cal outcomes of endoscopicmucosal resection of early gastric cancer[J].Hepatogastroenterology,2006,53(70):643-647.
[2] 杜智敏,郭宜斌.抽样调查与SPSS应用[M].北京:电子工业出 版社,2010:651-656.
[3] 王明慧,陆广春.城镇女性患者生育费用影响因素的通径分析 [J].中国卫生统计,2011,28(3):250-252.
[4] 孙尚拱.医学多变量统计与统计软件[M].北京:北京医科大学出 版社,2000:163-216.
[5] 任意.胃癌临床病理资料的回顾性研究[D].天津:天津医科大学, 2012.
[6] 涂洪谊,吴晶.不同等级医院医保老年患者住院费用分析[J].中 国公共卫生,2009,25(8):1015-1016.
[7] 石玲燕,金嵘,郑荣远,等.温州地区脑卒中住院患者费用分析 [J].中国公共卫生,2006,22(8):1022-1023.
[8] 寸晓乐,冯向先,李韶霞.综合医院胃癌患者3287例住院费用分 析[J].中国公共卫生,2010,26(6):703-704.
[9] 肖静,杨梅,魏珊,等.南通市2020例乳腺癌患者住院费用影响 因素的通径分析[J].中国妇幼保健,2012,27(11):1617-1620.
[10] 杨梅,高月霞,肖静.南通市老年恶性肿瘤患者住院费用影响因 素的通径分析[J].中国老年学杂志,2012,32(17):3732-3735.
[11] 谢修强,陈锋.扬州市某医院胃癌病人住院费用影响因素分析 [J].现代医院管理,2008,27(6):29-31.
[12] 王明慧,曹乾,陆广春.城镇医保患者住院总费用及个人支付费 用影响因素的通径分析[J].现代预防医学,2009,36(3):457-460.
[13] 莫春梅,倪宗瓒,张琴.单病种费用影响因素的通径分析[J].中国 医院统计,1999,6(4):213-215.
[14] 吴秀娟,卓朗,王健,等.综合性医院老年住院病人住院费用分析 [J].中国老年学杂志,2007,27(12):1191-1193.

备注/Memo

备注/Memo:
作者简介：曾军杰，硕士，主治医师，研究方向：流 行病学和卫生统计 通信作者：曾军杰，E-mail: zengjunjie1979@163.com
更新日期/Last Update: 2016-03-18