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| Surgical cost analysis and management recommendations for gastric cancer patients in a third-level general hospital in Southwest China |
| GU Yonghong1,2 CHEN Yilong1,2 YING Zhiye1,2 ZHANG Pengfei1 CUI Huanhuan3 ZHU Ting1,2 ZENG Xiaoxi1,2 SUN Lin3▲ |
1.Center of Biomedical Big Data, College of Clinical Medicine, West China Hospital Sichuan University, Sichuan Province, Chengdu 610041, China;
2.Center of Medical Big Data, Sichuan University, Sichuan Province, Chengdu 610041, China;
3.Office of Medical Insurance, College of Clinical Medicine, West China Hospital Sichuan University, Sichuan Province, Chengdu 610041, China |
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Abstract Objective To analyze the cost, cost composition and influencing factors of gastric cancer surgery patients in a third-level general hospital in Southwest China, and to provide a reference for the management and decision-making of medical institutions, medical insurance institutions and health regulatory agencies. Methods Descriptive statistics, single factor correlation analysis and multiple linear stepwise regression were used to analyze the average cost of hospitalization for gastric cancer surgery patients (5868 person-times) and influencing factors from January 2011 to December 2017 in a large tertiary general hospital in Southwest China. Results From 2011 to 2017, the average cost of hospitalization for gastric cancer patients in the top three hospitals was 59 186.46 yuan. The examination expenses, surgical expenses, and nursing expenses per time of gastric cancer surgery patients were constituted an increasing trend. Old age, long hospital stay, type of healing, male, presence of comorbidities and complications, total gastrectomy and year were risk factors for the cost of gastric cancer surgery (OR ＞ 1, P ＜ 0.05), while the type of incision and other types of surgery were the protective factors for the cost of gastric cancer surgery (OR ＜ 1, P ＜ 0.05). Conclusion Medical expenses are increasing rapidly, and the status of expenses reflecting the labor value of medical workers has improved, howere, it is still at a low level. The relatively controllable factors affecting medical expenses are mainly the length of hospital stay.
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[1] Ferlay J，Shin H，Bray F，et al. Estimates of worldwide burden of cancer in 2008：GLOBOCAN 2008 [J]. Int J Cancer，2010，127（12）：2893-2917.
[2] Chen W，Zheng R，Baade PD，et al. Cancer Statistics in China，2015 [J]. Ca Cancer J Clin，2016，66（2）：115-132.
[3] 朱雪雪，张玉，刘宏宇，等.胃癌患者住院费用及影响因素分析[J].中国卫生经济，2019，38（2）：67-71.
[4] 聂蓬，李春波，苏韫，等.武威地区胃癌根治术患者单次住院费用影响因素分析[J].中国病案，2019，20（10）：52-55.
[5] Ma C，Li Y，Shia B，et al. Human disease cost network analysis [J]. Stat Med，2020.
[6] Japanese gastric cancer treatment guidelines 2014（ver. 4） [J]. Gastric Cancer，2017，20（1）：1-19.
[7] 沈掩瑜，赵明，朱琳，等. 医院医保精细化管理策略探讨[J].中国医疗保险，2019（12）：53-55.
[8] 许建强，杜羽茜，郑娟.不同医疗保险类型胃癌患者住院费用分析[J].中国病案，2019，20（7）：65-68.
[9] 杜剑亮，刘骏峰，陈倩.常用DRGs模型的评价方法[J].中国病案，2014，15（8）：36-37.
[10] 周杰华，孔旭辉，黄秀芹，等.基于临床路径下胃癌手术患者住院费用及影响因素分析[J].中国现代药物应用，2017，11（16）：79-81.
[11] 袁莎莎，孟庆跃.医疗服务质量和费用关系的国际研究综述[J].中国卫生政策研究，2014（10）：46-51.
[12] 罗莉，周希喆，魏伟，等.转诊患者治疗床位和康复床位医疗费用影响因素分析[J].中国卫生质量管理，2018， 25（2）：41-43.
[13] 冯俊，李英利，徐婷婷，等.基于结构变动度的三甲综合医院2014～2016年住院费用结构评价[J].中国医药导报，2018，15（13）：147-150.
[14] 王淑强，钟文洲.结直肠癌患者住院费用构成分布及其影响因素分析[J].中国医药导报，2019，16（23）：118-121.
[15] 魏亚卿，李育民，裴正学，等.胃癌患者住院费用及影响因素的通径分析[J].中国肿瘤，2018，27（8）：596-600.
[16] 范青丹，罗素新，沈健，等.急性ST段抬高型心肌梗死患者住院费用影响因素分析[J].现代医药卫生，2019， 35（17）：2620-2623.
[17] 金萍妹.某三级甲等肿瘤医院药品零差率实施效果分析[J].中国医院管理，2017，37（6）：14-16.
[18] 张颖，段利忠，周渝金，等.患者视角下医疗服务价格改革执行效果研究[J].中国医药导报，2019，16（29）：179-184.
[19] 马丽文，宫春博.山东省公立医院医疗费用控制效果分析[J].中国医药导报，2019，16（25）：171-174.
[20] Florea A，Sangare L，Lowe K. A Multinational Assessment of Gastric，Esophageal，and Colorectal Cancer Burden： A Report of Disease Incidence，Prevalence，and Fatality [J]. J Gastrointest Cancer，2019. |
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