基于DRG组的年龄和术式对肺癌手术患者住院费用的影响

doi:10.3969/j.issn.1006-5253.2024.04.003

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摘要目的分析年龄和术式对肺癌手术患者住院费用的影响。方法以宁波市某三甲医院2022年1月1日至2022年12月31日主要诊断为肺癌（C34.）的手术患者为研究对象，对其诊断相关分组（DRG）入组情况进行分析。采用t检验和方差分析从年龄和术式对DRG组中患者费用进行差异性分析。结果 2 489例肺癌手术患者均被分到了EB1胸部大手术组。EB11胸部大手术，伴严重并发症与合并症组年龄和术式对患者费用的影响无统计学差异（P>0.05）。EB13胸部大手术、伴一般并发症与合并症组，EB15胸部大手术、不伴并发症与合并症组60岁以上患者住院费用显著高于60岁以下患者（P＜0.05）。随着年龄的增加，住院费用增加，医院医保亏损金额越大，差异具有统计学意义（P＜0.05）。EB13组除肺叶切除与全肺切除住院费用无统计学差异外，其余术式间患者住院费用差异均有统计学意义（P＜0.05）；EB15组除肺叶部分切除、肺叶切除均与全肺切除住院费用无差异外，其余术式间差异均有统计学意义（P＜0.05）。随着手术切除范围增大，住院费用增高，医院医保亏损越多，差异具有统计学意义（P＜0.05）。结论肺癌手术患者住院费用受年龄和手术术式的影响较大，在DRG分组方案优化时，应提高与临床的契合度，在充分考虑临床实际情况下进一步细化。

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	曾祥嫚

关键词 ：诊断相关分组, 肺癌手术, 年龄, 术式, 住院费用

Abstract：Objective To analyze the impact of age and surgical procedures on hospitalization costs for lung cancer patients undergoing surgery.Methods The study focused on surgical patients who were primarily diagnosed with lung cancer (C34.) in a tertiary hospital in Ningbo from January 1, 2022 to December 31, 2022, and analyzed their DRG enrollment status. Differential analysis of patient costs in the DRG group using t-test and analysis of variance based on age and surgical procedures.Results A total of 2 489 lung cancer surgery patients were all assigned to the EB1 chest surgery group. There was no statistically significant difference (P>0.05) in the impact of age and surgical procedures on patient costs between EB11 major chest surgery with severe complications and comorbidities. The hospitalization costs of patients over 60 years old in the group of EB13 major chest surgery with general complications and comorbidities and in the group of EB15 major chest surgery without complications and comorbidities were significantly higher than those of patients under 60 years old (P<0.05). As age increased, hospitalization costs increased, and the amount of medical insurance losses in hospitals increased, with statistical significance (P<0.05). Except for no difference in hospitalization costs between lobectomy and total pneumonectomy, there was a statistically significant difference in hospitalization costs among other surgical procedures in the EB13 group (P<0.05). Except for no difference in hospitalization costs between partial lobectomy, lobectomy and pneumonectomy, all other surgical procedures showed statistically significant differences (P<0.05) in the EB15 group. As the surgical resection range increased, hospitalization costs increased, the medical insurance losses increased in the hospital, and the difference was statistically significant (P<0.05).Conclusion The hospitalization costs of lung cancer patients undergoing surgery are greatly influenced by age and surgical procedures. When optimizing the DRG grouping scheme, it is necessary to improve the compatibility with clinical practice and further refine it with full consideration of the actual clinical situation.

Key words： diagnosis related grouping (DRG) lung cancer surgery age surgical procedure hospitalization cost

收稿日期: 2024-02-20

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基金资助:朱绣山先生人才奖励基金（2023HMYQ32）

通讯作者: 曾祥嫚, Email: zengxiangman8806@126.com

引用本文:

曾祥嫚. 基于DRG组的年龄和术式对肺癌手术患者住院费用的影响[J]. 中国医院统计, 2024, 31(4): 253-257.
Zeng Xiangman. Impact of age and surgical approach on hospitalization costs of lung cancer patients undergoing surgery based on DRG grouping. journal1, 2024, 31(4): 253-257.

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http://manu58.magtech.com.cn/Jwk_zgyytj/CN/10.3969/j.issn.1006-5253.2024.04.003 或 http://manu58.magtech.com.cn/Jwk_zgyytj/CN/Y2024/V31/I4/253

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