甲状腺癌患者住院费用影响因素分析
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摘要
目的 :分析某院甲状腺癌患者住院费用情况及影响因素并进行疾病分组探索,为医院加强费用控制与临床诊疗服务管理提供依据。结果 :五年间收治量逐年上升,男女比为1∶2.36,大部分患者住院8天以内、非手术治疗、花费15000-20000元等;实行后付制支付方式的医保范围内的医疗费用高于预付制方式下的医疗费用,手术治疗费用高于非手术治疗,住院天数越长或年龄越大费用越高;住院天数、收治科室、治疗方式为住院费用的主要影响因素,病例分组中住院天数超过8天的费用高于其他情形。建议:推行临床路径管理,规范合理诊疗,降低医疗成本;加快按病种付费改革,细化支付标准,从控制费用转换到为患者购买成本效益好的医疗服务。
To analyze the hospitalization cost and influencing factors of thyroid cancer patients in a hospital,and to explore the disease grouping, and to provide the basis for strengthening the cost control and clinical management service. The ratio of male to female was 1:2.36,the majority of patients were hospitalized within 8 days,surgical treatment costs higher than non-surgical treatment, the longer the hospital stay the cost of patients is relatively high;hospital days,admitted departments,the treatment of hospitalization costs as the main factors,the cost of hospitalization in the case group is more than 8 days higher than in other cases.After that,The clinical path management should be carried out,the medical cost should be reduced,the service efficiency should be improved;the reform of the payment method should be accelerated, the standard of the fee and the cost control should be refined.
To analyze the hospitalization cost and influencing factors of thyroid cancer patients in a hospital,and to explore the disease grouping, and to provide the basis for strengthening the cost control and clinical management service. The ratio of male to female was 1:2.36,the majority of patients were hospitalized within 8 days,surgical treatment costs higher than non-surgical treatment, the longer the hospital stay the cost of patients is relatively high;hospital days,admitted departments,the treatment of hospitalization costs as the main factors,the cost of hospitalization in the case group is more than 8 days higher than in other cases.After that,The clinical path management should be carried out,the medical cost should be reduced,the service efficiency should be improved;the reform of the payment method should be accelerated, the standard of the fee and the cost control should be refined.
引文
[1]杜倩,于莉莉,赵晶,等.1393例甲状腺癌临床特点分析[J].中国病案,2016,17(02):64-67.
[2]陈治水,冷家骅,高广颖,等.五类肿瘤疾病住院费用及其影响因素分析[J].中国卫生经济,2014(07):57-60.
[3]张园,姚瑶.江苏地区分化型甲状腺癌诊疗现状及对策[J].中国肿瘤外科杂志,2017,9(4).
[4]La Vecchia C,Mal vezzi M,Bosetti C,et al.Thyroid cancer mor-tality and incidence:a global overview[J].Int J Cancer,2015,136(9):2187-2195.
[5]朱洁,金萍妹,华伟,等.15348例宫颈癌不同治疗方式的住院费用研究[J].中国医院管理,2017,37(02):58-60.
[6]金萍妹,华伟,陈洁,等.10种常见恶性肿瘤住院费用构成及影响因素研究[J].中国医院,2016,20(08):43-45.
[7]Jia Xiaoqiang,Yang Yufei,Xu Renzhong,etc.Influencing factor analysis on hospitalization costs of 3046 cases with colorectal cancer on basic medical insurance in Beijing[J].World Science
[8]吕红亮,赵少峰,谢小萍,等.四川省16866例肺癌患者住院费用影响因素分析[J].中国循证医学杂志,2013,13(11):1283-1287.
[9]张敏,赵琨,李雪,等.青岛市某医院临床路径改革对医疗费用影响的ITS分析[J].中国卫生经济,2016,35(02):67-68.
[10]王丹,邢沫.5个肿瘤病种实施临床路径对缩短住院日和降低次均费用的效果分析[J].中国医院,2013(10):32-33.
[11]吕凯男,江芹,王珊,等.混合式支付方式对住院费用影响的探讨[J].中国卫生经济,2017,36(04):43-46.
[12]杨永梅,陈翰丹.医保支付方式对医生行为约束的路径分析[J].中国卫生政策研究,2015,8(12):31-35.
[2]陈治水,冷家骅,高广颖,等.五类肿瘤疾病住院费用及其影响因素分析[J].中国卫生经济,2014(07):57-60.
[3]张园,姚瑶.江苏地区分化型甲状腺癌诊疗现状及对策[J].中国肿瘤外科杂志,2017,9(4).
[4]La Vecchia C,Mal vezzi M,Bosetti C,et al.Thyroid cancer mor-tality and incidence:a global overview[J].Int J Cancer,2015,136(9):2187-2195.
[5]朱洁,金萍妹,华伟,等.15348例宫颈癌不同治疗方式的住院费用研究[J].中国医院管理,2017,37(02):58-60.
[6]金萍妹,华伟,陈洁,等.10种常见恶性肿瘤住院费用构成及影响因素研究[J].中国医院,2016,20(08):43-45.
[7]Jia Xiaoqiang,Yang Yufei,Xu Renzhong,etc.Influencing factor analysis on hospitalization costs of 3046 cases with colorectal cancer on basic medical insurance in Beijing[J].World Science
[8]吕红亮,赵少峰,谢小萍,等.四川省16866例肺癌患者住院费用影响因素分析[J].中国循证医学杂志,2013,13(11):1283-1287.
[9]张敏,赵琨,李雪,等.青岛市某医院临床路径改革对医疗费用影响的ITS分析[J].中国卫生经济,2016,35(02):67-68.
[10]王丹,邢沫.5个肿瘤病种实施临床路径对缩短住院日和降低次均费用的效果分析[J].中国医院,2013(10):32-33.
[11]吕凯男,江芹,王珊,等.混合式支付方式对住院费用影响的探讨[J].中国卫生经济,2017,36(04):43-46.
[12]杨永梅,陈翰丹.医保支付方式对医生行为约束的路径分析[J].中国卫生政策研究,2015,8(12):31-35.