Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China; Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, China.
Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha, China; Institute of Oral Precancerous Lesions, Central South University, Changsha, China; Research Center of Oral and Maxillofacial Tumor, Xiangya Hospital, Central South University, Changsha, Hunan 410000, China.
Oral Oncol. 2021 Aug;119:105363. doi: 10.1016/j.oraloncology.2021.105363. Epub 2021 Jun 26.
To provide information about hospitalization costs and length of stay (LOS) for inpatients undergoing oral cancer (OC) surgery, and to investigate the association of hospitalization costs and LOS with demographics, tumor subsite, surgery-related and hospital characteristics.
Data extracted from Chinese National Health Statistics Network Reporting System database in Hunan, China during 2017-2019 were analyzed using quantile regression models.
A total of 6,420 OC patients undergoing surgery were identified. After controlling potential compounding variables, the median hospitalization cost was significantly higher in male than in female patientsby $515.70 at the median (p < 0.001). Patients aged over 60 hadsignificantly less costs by $294.85 at the meanthan did those below 60, while no differenceof LOS existed across age. OC patients with neck dissection had significantly higher costs by $1,983.33 at the median than those without (P < 0.001). Regional flaps were the most economical, with lower costs than free flaps by $3,084 (P < 0.001) and the pectoralis major myocutaneous flap (PMMF) by $549.45 (P < 0.001) at the median.
Male is a significant driver of hospitalization costs and LOS for OC, and age over 60 is associated with lower costs, but not with LOS. Mouth primary site is associated with the highest costs and LOS, while lip primary site the lowest. Absence of neck dissection in early-stage OC can significantly reduce costs and LOS, but its oncological validity needs more evidence. Regional flaps are less expensive than free flaps and the PMMF for oral reconstruction, and are recommended in select patients.
提供接受口腔癌（OC）手术的住院患者住院费用和住院时间（LOS）的信息，并调查住院费用和 LOS 与人口统计学、肿瘤部位、手术相关和医院特征的关联。
使用定量回归模型分析了 2017 年至 2019 年期间从中国国家卫生统计网络报告系统数据库中提取的湖南数据。
共确定了 6420 名接受手术的 OC 患者。在控制潜在的复合变量后，男性患者的中位住院费用比女性患者高 515.70 美元（p < 0.001）。60 岁以上的患者比 60 岁以下的患者的费用低 294.85 美元，中位值，而 LOS 没有差异。颈清扫术的 OC 患者的中位费用比未行颈清扫术的患者高 1983.33 美元（P < 0.001）。区域皮瓣是最经济的，与游离皮瓣相比费用低 3084 美元（P < 0.001），与胸大肌肌皮瓣（PMMF）相比费用低 549.45 美元（P < 0.001）。
男性是 OC 住院费用和 LOS 的重要驱动因素，60 岁以上与较低的费用相关，但与 LOS 无关。口腔原发部位与最高的费用和 LOS 相关，而唇原发部位则相反。早期 OC 无颈清扫术可显著降低费用和 LOS，但需要更多证据证明其肿瘤学有效性。对于口腔重建，区域皮瓣比游离皮瓣和胸大肌肌皮瓣便宜，建议在选择的患者中使用。
