消化系统恶性肿瘤手术患者住院费用影响因素分析

目的 探讨影响消化系统恶性肿瘤手术患者住院费用的因素,为医院医疗质量控制管理和地区肿瘤单病种的费用控制管理提供参考数据信息.方法 利用某院2004-2009年住院首页消化系统恶性肿瘤手术病例的数据,分析住院费用的构成,对影响人均住院费用的因素进行方差分析和单因素回归分析.结果 影响消化系统恶性肿瘤住院手术病例人均住院费用的因素有性别、年龄、平均住院日、出院年份、伴有其他非肿瘤疾病、院内感染及并发症等.1 537例病例人均住院费用的中位数为40 162元,男性人数比女性人数多,男性病例人均住院费用比女性高.年龄分布高峰在50～64岁,人均住院费用随着病例年龄的增长逐渐增多,在65～74岁到达最高.平均住院天数为25.4天,30%病例住院天数大于25天,人均住院费用随着病例住院天数的增加而上升.发生院内感染和手术后并发症的病例人均住院费用明显高于没有发生的病例费用,伴有其他疾病的人均住院费用比没有合并其他疾病的病例多.结论 医院医疗质量控制管理可采用规范合理用药,缩短平均住院日,控制院内感染和手术后并发症的发生等措施来达到控制单病种费用及最大效率利用卫生资源的医疗服务目标.

Analysis of related factors to hospitalized expense for surgical patients with carcinoma of digestive system

Objective To study factors related to hospitalized expense for surgical patients with carcinoma of digestive system, and to provide a basis for performing the medical management and controlling increase of medical expenses of treatment. Methods Data was collected from carcinoma of digestive system with surgical inpatient cases during 2004-2009 were analyzed by SPSS13.0 version, one-way analysis of variance and linear regressions were applied in this study. Results Hospital expense was related to sex, age, the average days of hospitalization, hospitalized year, other accompanying disease, nosocomial infection and complication in univariable statistical analysis. The median hospital expense for the total of 1 537 patients were 40 162 yuan, male inpatients were more than female, male spend money on disease more than femalel The peak age incidence was between 50 and 64 years old. Hospital expense was higher with increase of age, the peak was between 65 and 74 years old. The average days of hospitalization were 25.4 days, 30% inpatients live in hospital more than 25 days, hospital expense was higher with increase of the average days of hospitalization, patients acquired infection and complication in hospital spend money much higher than others, other accompanying disease of patients spend more money. Conclusion Control the irrational increase of medical expense, shorten the average days of hospitalization, reduced nosocomial infection and complication will be major measures to reach target of the rational and effectual utilization of medical resources .