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目的探讨食管癌手术患者住院费用的影响因素及作用程度,为有效减轻患者经济负担及合理控制医疗费用的过快增长提供参考。方法通过对某三甲综合医院2012年-2014年出院的561例食管癌手术患者进行通径分析研究其住院费用的影响因素,应用SPSS17.0统计软件进行多元线性回归分析。结果住院天数是直接影响住院费用的最主要因素(标准化回归系数=0.3950,P<0.001),年龄、民族、有无伴随疾病和肿瘤分期情况影响住院费用不仅存在直接效应(直接通径系数分别为0.1350、-0.1390、0.0980、-0.0780)而且存在间接效应(间接通径系数分别为0.0920、-0.0830、0.0440、-0.0030),且民族及肿瘤分期情况影响住院费用的效应为负相关。结论住院天数和年龄是影响住院费用最大的因素,建立食管癌规范化临床路径,缩短住院天数,为有效控制和减轻食管癌患者疾病负担提供依据。
Objective To explore the influencing factors and the degree of hospitalization of patients with esophageal cancer surgery and provide reference for effectively reducing the financial burden on patients and reasonably controlling the excessive growth of medical expenses. Methods A total of 561 cases of esophageal cancer patients who were discharged from hospital in 2012-2014 in our hospital were studied by path analysis. The influential factors of hospitalization expenses were analyzed by SPSS17.0 statistical software for multiple linear regression analysis. Results The length of hospital stay was the most significant factor (RR = 0.3950, P <0.001) which directly influenced the hospitalization costs. There was not only direct effect on hospitalization expenses due to age, ethnicity, presence of comorbidities and tumor staging (direct path coefficients were (Indirect path coefficient were 0.0920, -0.0830, 0.0440, -0.0030, respectively), and the effect of nationality and tumor staging on hospitalization costs was negatively correlated. Conclusion The length of hospital stay and age are the most important factors that affect the hospitalization cost. Establishing a standardized clinical path of esophageal cancer and shortening the length of hospitalization provide the basis for effectively controlling and reducing the burden of disease in esophageal cancer patients.