886 例乳腺癌病人住院费用影响因素分析

目的分析影响女性乳腺癌患者住院费用的因素，为完善医疗保障制度、合理分配医疗资源和医疗费用分析提供参考依据。方法对山西省某综合医院2004—2011年886例乳腺癌患者住院费用的构成、影响因素等进行分析，采用非条件Logistic回归法分析乳腺癌患者住院费用的影响因素。结果2004—2011年该院乳腺癌患者住院人数、平均住院费用及日均住院费用总体呈上升趋势；住院费用主要用在药品购买（36．83％）、手术（21．69％）、化验（10．22％）等方面；影响住院费用的主要因素依次为付费方式、住院天数、病理类型、药占比、化验费占比（均有P〈0．05）。结论付费方式、住院天数、病理类型、药占比、化验费占比是影响住院费用的主要因素，建议加强对医院药物的科学合理使用、提升医务人员医疗技术和服务水平、缩短住院天数及完善医保制度等措施以有效控制医疗费用增长。

Analysis on hospitalization costs in 886 breast-cancer cases

Objective To analyze influencing factors of hospitalization costs in women with breast cancer, to pro vide evidences for the improvement of the medical security system and to prevent breast cancer. Methods Data on hospitalization costs of 886 breast-cancer inpatients in a consolidated hospital in Shanxi Province from 2004 to 2011 were analyzed with the unconditional logistic regression analysis. Results From 2004 to 2011, the cost of inpatient was mainly used in pharmaceuticals, assay, operative and other aspects. The number of hospitalizations, the average cost of hospitali- zation and average daily hospitalization cost were all increased. Main influencing factors of hospitalization expenditure of breast-cancer inpatients were the occupation, the days of hospitalization, the pathological types, the discharged circum- stances, the proportion of drug, assay and surgery costs, and with or without complications （ all P 〈 0. 05 ）. Conclusions Comprehensive measures to control health care costs are effective. It is recommended to use drugs rationally, to enhance skills of medical staff, to shorten the length of hospitalization and to improve the heath care system to control the growth of medical costs effectively.