结直肠癌患者手术并发症分级系统构建及费用验证研究

目的:搭建适宜的结直肠癌手术并发症分级系统,探索并发症影响因素,依托住院费用对分级系统进行验证,与DRG支付标准比较,为病种支付制度的细化提供参考。方法:回顾收集样本医院2016—2022年的病案信息数据,用logistic分析并发症的影响因素,用非参Kruskal-Wallis法检验不同并发症分级之间的费用差异。结果:并发症发生率为56.41%。多脏器切除、使用腹腔镜、男性和年龄是并发症发生的风险性因素,而高分化程度和在专病胃肠中心科室救治是保护性因素。术后并发症等级越高,住院费用中位数明显越高。结论:需要不断控制术后并发症以缓解结直肠癌患者的经济负担;搭建的结直肠癌手术并发症分级系统具有统计上的费用指示性,能够为病种付费的细化发展提供一定的参考依据。

Analysis on the Construction and Cost Verification of Complication Grading System for Colorectal Cancer Patients

Objective: To establish a complication grading system for patients with colorectal cancer surgery, explore the influenc- ing factors, verify the complication grading system based on the hospitalization expenses, and compare with DRG payment standard, so as to provide references for the improvement of the disease payment system. Methods: The medical records of 7 years were retrospec- tively collected, and the risk factors of complications were analyzed by Logistic analysis, and the differences of hospitalization expens- es among different complication grades were tested by Kruskal-Wallis method. Results: The incidence of complications was 56.41%. Multiple organ resection, use of laparoscopy, male and age were risk factors for complications, while high differentiation and treatment in the special gastrointestinal center were protective factors. The higher the level of postoperative complications is, the higher the medi- an hospitalization cost will be. Conclusion: Postoperative complications need to be controlled to alleviate the economic burden of colorectal cancer patients. The established classification system for colorectal cancer surgery complications has been proved to be sta- tistically indicative of costs, and can provide references for the development of disease payment.