Gu Yichun, Liu Mengying, Wang Anqi, He Da, Sun Hui, Cui Xin, Tian Wenqi, Zhang Yulin, Jin Chunlin, Wang Haiyin
Shanghai Health Development Research Center, Shanghai, China.
School of Pharmacy, Anhui Xinhua University, Hefei, Anhui, China.
Value Health Reg Issues. 2024 Nov;44:101029. doi: 10.1016/j.vhri.2024.101029. Epub 2024 Aug 1.
This study analyzed the basic condition and the influencing factors of hospitalization costs of patients with gastric cancer in Shanghai from 2014 to 2021, so as to provide a scientific reference for promoting the reform of the medical and healthcare system.
The study data were obtained from the electronic medical record system of Shanghai Hospital. The grey relational analysis was applied to analyze the correlation strength of various expenses with hospitalization costs. The structural equation modeling was constructed to analyze the influences of factors on the hospitalization expenses, as well as the relationship between each factor.
A total of 23 335 study subjects were included. The results of grey relational analysis showed that the total cost of drugs had the strongest correlation with hospitalization expenses, followed by material expenses and surgery cost, whereas those of others were lower. The results of the structural equation modeling showed that age had the greatest influence on hospitalization expenses with a path coefficient of 0.618. Other influencing factors included surgery history, length of stay, hospital level, gender, and medical insurance.
The total cost of drugs had the strongest correlation with hospitalization expenses. Factors such as gender, age, and hospital level all affect the hospitalization expenses. In the future, it is necessary to take further measures to control the cost of drugs and constantly optimize the structure of hospitalization costs. Meanwhile, the reform of the medical and healthcare system should be deepened to reasonably regulate the medical behaviors and reduce the financial burden of patients.
本研究分析了2014年至2021年上海市胃癌患者的住院费用基本情况及影响因素,旨在为推进医疗卫生体制改革提供科学参考。
研究数据来源于上海市医院电子病历系统。运用灰色关联分析方法分析各项费用与住院费用的关联强度。构建结构方程模型分析各因素对住院费用的影响以及各因素之间的关系。
共纳入23335名研究对象。灰色关联分析结果显示,药品总费用与住院费用的相关性最强,其次是材料费用和手术费用,其他费用的相关性较低。结构方程模型结果显示,年龄对住院费用的影响最大,路径系数为0.618。其他影响因素包括手术史、住院天数、医院级别、性别和医疗保险。
药品总费用与住院费用的相关性最强。性别、年龄、医院级别等因素均影响住院费用。未来,有必要进一步采取措施控制药品费用,不断优化住院费用结构。同时,应深化医疗卫生体制改革,合理规范医疗行为,减轻患者经济负担。