Fan Yi, Yang Qiujiao, Chen Chen, Hu Xiaoying, Xu Mingming, Weng Yanfeng, Li Yanni, Wang Yaping, Lin Lisong, Qiu Yu, Wang Jing, Chen Fa, He Baochang, Liu Fengqiong
Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China.
Department of Occupational and Environmental Health Sciences, Peking University, Beijing, China.
BMJ Open. 2025 Jan 25;15(1):e087060. doi: 10.1136/bmjopen-2024-087060.
To investigate the associations between influencing factors with length of stay (LOS) and hospitalisation expenses in oral cancer (OC) patients, and to explore the potential pathways through which these factors influence hospitalisation expenses using path analysis.
Cross-sectional.
A comprehensive tertiary hospital in southeastern China.
A total of 810 patients with histologically confirmed primary OC admitted to the First Affiliated Hospital of Fujian Medical University, Fujian Province, between 2015 and 2020.
LOS and hospitalisation expenses for OC patients.
The median hospitalisation expenses and LOS for OC patients in southeastern China were substantial, amounting to $6330 and 29 days, respectively. Treatment and surgery fees constituted the largest proportion of total expenses (28.59%), followed by inspection and laboratory test fees (20.63%), comprehensive medical service fees (19.27%), drug fees (18.09%) and medical consumables fees (11.69%). LOS was significantly associated with tumour site, surgery and chemotherapy. Factors such as longer LOS, poor oral hygiene, advanced tumour stage (II-IV), larger tumour size (>2 cm), surgery and bilateral neck dissection were strongly linked to higher hospitalisation expenses. Path analysis revealed that neck dissection had the highest total effect on hospitalisation expenses (=0.307), while surgery exerted an indirect effect on expenses via LOS (=0.021).
This study highlights the significant economic burden imposed by OC on patients and healthcare systems. While prevention and early diagnosis remain critical, our findings underscore several modifiable factors, including improving oral hygiene and optimising surgical protocols, such as chemotherapy and lymph node dissection, that present opportunities to reduce costs and enhance cost-effectiveness. These insights provide actionable targets for mitigating financial burdens and improving patient outcomes.
探讨口腔癌（OC）患者影响因素与住院时间（LOS）及住院费用之间的关联，并通过路径分析探索这些因素影响住院费用的潜在途径。
横断面研究。
中国东南部一家综合性三级医院。
2015年至2020年间在福建省福建医科大学附属第一医院收治的810例经组织学确诊的原发性OC患者。
OC患者的住院时间和住院费用。
中国东南部OC患者的住院费用中位数和住院时间均较高，分别为6330美元和29天。治疗和手术费用占总费用的比例最大（28.59%），其次是检查和检验费用（20.63%）、综合医疗服务费（19.27%）、药品费（18.09%）和医用耗材费（11.69%）。住院时间与肿瘤部位、手术和化疗显著相关。住院时间较长、口腔卫生差、肿瘤分期较晚（II-IV期）、肿瘤较大（>2 cm）、手术和双侧颈清扫等因素与较高的住院费用密切相关。路径分析显示，颈清扫对住院费用的总效应最高（=0.307），而手术通过住院时间对费用产生间接效应（=0.021）。
本研究强调了OC给患者和医疗系统带来的巨大经济负担。虽然预防和早期诊断仍然至关重要，但我们的研究结果强调了几个可改变的因素，包括改善口腔卫生和优化手术方案，如化疗和淋巴结清扫，这些因素为降低成本和提高成本效益提供了机会。这些见解为减轻经济负担和改善患者预后提供了可操作的目标。
