安宁疗护对恶性肿瘤死亡患者住院费用的影响分析

目的 了解安宁疗护对恶性肿瘤死亡患者住院费用的影响。方法 回顾性收集2010年10月至2019年12月南京大学医学院附属鼓楼医院肿瘤科死亡病例共302例，比较接受安宁疗护的患者与未接受安宁疗护患者的资料，通过影响因素分析了解安宁疗护在住院费用中所起的作用。结果与未接受安宁疗护的恶性肿瘤死亡患者相比，接受安宁疗护的恶性肿瘤死亡患者平均住院费用、治疗费、检查费、药费、护理费均低于非安宁疗护组（均P＜0.001）。单因素分析结果显示，安宁疗护、医疗支付方式与住院费用有关(均P＜0.05)。多元线性逐步回归分析结果显示，安宁疗护是影响住院费用的主要因素(P=0004)。结论 安宁疗护可在一定程度上降低恶性肿瘤终末期患者的住院费用，医疗支付方式也可影响恶性肿瘤终末期患者的住院费用，应采取综合性措施控制住院费用，减轻患者经济负担。

The impact of palliative care on hospitalization expenses of dying patients with malignant tumor

Objective To investigate the effect of palliative care on the hospitalization cost of dying patients with malignant. Methods A total of 302 patients who died in the Department of Oncology, Drum Tower Hospital Affiliated to Nanjing University Medical School from October 2010 to December 2019 were retrospectively collected. The clinical data of patients who received palliative care and those who did not receive palliative care were compared. The role of palliative care in the cost of hospitalization was analyzed. Results Compared with the malignant tumor patients who did not receive palliative care, the average hospitalization cost, treatment cost, examination cost, drug cost and nursing cost of the malignant tumor patients treated with palliative care decreased significantly (P<0.001). Univariate analysis showed that hospice care and type of medical payment were related to hospitalization costs (P<0.05). Multiple linear stepwise regression analysis suggested that palliative care was the main factor affecting the hospitalization cost (P=0.004). Conclusions The application of palliative care reduces the hospitalization cost of patients with terminal malignant tumor. And the type of medical payment affects the hospitalization cost of patients with terminal malignant tumor as well. Comprehensive measures should be taken to control the hospitalization cost and reduce the economic burden of patients.