摘要
目的分析腹腔镜下直肠癌手术患者住院费用结构变化趋势和相关原因,为优化费用结构、控制费用不合理增长提供参考依据。方法选取2019年1月1日-2023年12月31日四川省某三级甲等医院直肠癌经腹腔镜手术治疗出院患者762例作为研究对象,运用结构变动度法分析患者住院费用结构变动情况。结果纳入研究的762例腹腔镜下直肠癌手术患者,2019年-2023年直肠癌经腹腔镜手术患者住院费用低幅上涨,总体结构变动度为10.9%,其中2021年-2022年的结构变动度最大(5.69%)。5年间,耗材费和诊断费占比呈正向变化,治疗费、其他费用、综合医疗服务费和药品费占比呈负向变化。其中,治疗费的结构变动值为-4.31%,其变动幅度最大。对住院费用结构变动贡献率排名前3位的费用类别分别治疗费(39.53%)、耗材费(27.64%)和诊断费(22.36%),为影响住院费用的主要因素。结论腹腔镜下直肠癌手术患者住院费用控费措施取得一定成效,但费用结构尚不合理。需继续控制药品费用,降低物质要素费用占比,提高医务人员技术劳动价值,优化费用结构。
Objectives This study aims to analyze the changing trends and related reasons of the hospital expenses structure of patients undergoing laparoscopic rectal cancer surgery and provides a reference for optimizing the cost structure and controlling unreasonable cost growth. Methods A total of 762 discharged rectal cancer patients who underwent laparoscopic surgery at a tertiary A hospital in Sichuan Province between January 1, 2019, and December 31, 2023, were selected as the study subjects. The structural change degree method was used to analyze the structural change of hospitalization expenses of these patients. Results 762 patients with laparoscopic rectal cancer surgery were collected in this study. From 2019 to 2023, the hospitalization costs of patients undergoing laparoscopic surgery for rectal cancer increased slightly, with an overall structural change of 10.9%, among which the structural change from 2021 to 2022 was the largest(5.69%).Over the past five years, the proportion of consumables and diagnostic fees had changed positively, while the proportion of treatment fees, other fees,comprehensive medical service fees and drug fees had changed negatively. Among them, the structural change value of treatment expenses was-4.31%, with the largest change. The top three expense categories that contributed to the structural change of hospitalization expenses were treatment expenses(39.53%), consumables expenses(27.64%), and diagnostic expenses(22.36%), which were the main factors affecting hospitalization expenses.Conclusions The cost control measures for rectal cancer patients treated by laparoscopic surgery have achieved certain results, but the cost structure is not reasonable. It is suggested to use equivalent low-value consumables,implement mutual recognition of inspections, continue controlling drug costs, reduce the proportion of material costs, enhance the value of technical labor provided by medical personnel, and optimize the cost structure.
作者
杨芯昱
卢婷
严肃
牟莉萍
江华梅
廖娇
朱小凤
Yang Xinyu;Lu Ting;Yan Su;Mou Liping;Jiang Huamei;Liao Jiao;Zhu Xiaofeng(Suining Central Hosipital,Medical records Management Center,Suining 629000,Sichuan Province,China)
出处
《中国病案》
2025年第1期68-72,共5页
Chinese Medical Record
基金
遂宁市中心医院科研课题(2022yg102)。
关键词
直肠癌
腹腔镜
住院费用
结构变动度
Rectal cancer
Laparoscopy
Hospital expenses
Structural variation
