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

Abstract
Figure/Table
References (0)
Related Citation (15)

Download: PDF (3160 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS) Supporting Info

Guide

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

Received: 20 February 2024

PACS:

Fund:

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Zeng Xiangman

Cite this article:

Zeng Xiangman. Impact of age and surgical approach on hospitalization costs of lung cancer patients undergoing surgery based on DRG grouping[J]. journal1, 2024, 31(4): 253-257.

URL:

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

［1］邓小虹．北京DRGs系统的研究与应用［M］．北京：北京大学医学出版社，2015．

［2］王滨，张刚，姜晶，等．某妇幼保健院整合RBRVS和DRGs构建妇幼保健机构绩效评价体系［J］．中国医院，2023，27(5)：93-96．DOI: 10.19660/j.issn.1671-0592.2023.05.26.

［3］周伟丽，吕志丹，岳阳阳．DRGs付费对产科住院医保患者总费用的影响［J］．中国卫生统计，2019，36(5)：743-744．

［4］殷人易．DRGs应用于医院管理的问题及缺陷探讨［J］．中国医院管理，2019，39(3)：60-61．

［5］关国琼，陈爱民．医院DRGs推广应用中存在的问题与建议［J］．中国卫生信息管理杂志，2020，17(4)：485-488．DOI: 10.3969/j.issn.1672-5166.2020.04.016.

［6］CHARLSON M E, POMPEI P, ALES K L, et al. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation［J］. J Chronic Dis, 1987,40(5):373-383. DOI: 10.1016/0021-9681(87)90171-8.

［7］卢晓旭，吴慧，成灏，等．查尔森指数结合年龄分层评估老年食管癌患者对放化疗的耐受性［J］．中华老年医学杂志，2014，33(10)：1093-1096．DOI: 10.3760/cma.j.issn.0254-9026.2014.10.015.

［8］吕梦甜，孙菊，刘文宾，等．查尔森合并症指数对重型再生障碍性贫血患者的预后价值［J］．中华危重症医学杂志(电子版)，2020，13(4)：277-279．DOI: 10.3877/cma.j.issn.1674-6880.2020.04.007.

［9］付佳，肖海敏，武曦，等．年龄校正查尔森合并症指数对腹腔镜结直肠癌围手术期并发症的预测价值［J］．中华普通外科学文献(电子版)，2023，17(5)：336-341．DOI: 10.3877/cma.j.issn.1674-0793.2023.05.004.

［10］曾祥嫚，杨毓芳，王明红，等．2型糖尿病患者住院费用及影响因素研究［J］．医院管理论坛，2020，37(2)：21-25，40．DOI: 10.3969/j.issn.1671-9069.2020.02.006.

［11］彭浩，梁笃，李保林，等．查尔森合并症指数与老年股骨转子间骨折住院时间及费用的相关性研究［J］．中医药临床杂志，2019，31(5)：995-997．DOI: 10.16448/j.cjtcm.2019.0291.

［12］周伟，苍柏．肺癌手术患者住院费用构成及影响因素［J］．中国病案，2023，24(2)：77-80．DOI: 10.3969/j.issn.1672-2566.2023.02.026.

［13］张颖，李利杰，刘海容，等．支持向量机模型在肺癌病人住院费用影响因素分析中的应用［J］．中国医院，2014，18(10)：30-32．DOI: 10.3969/j.issn.1671-0592.2014.10.019.

［14］WORLD HEALTH ORGANIZATION. China country assessment report on ageing and health［M］.［S.l.］:World Health Organization,2015.

［15］卫安乐，冯文．脑缺血性疾病患者住院费用影响因素分析［J］．卫生经济研究，2023，40(12)：14-19．DOI: 10.14055/j.cnki.33-1056/f.2023.12.007.

［16］王晓立，袁亚芳，索丽君．常州市DRGs付费改革实践与成效分析［J］．江苏卫生事业管理，2023，34(1)：83-87．

［17］夏宇，陈英耀，杨毅．晚期非小细胞肺癌间接经济负担及其影响因素分析［J］．中国卫生经济，2023，42(8)：70-73．

［18］陈国标，周建平，杜巍，等．胸腔镜肺楔形切除术、胸腔镜下肺段切除术、胸腔镜肺叶切除术治疗早期肺癌的疗效比较研究［J］．实用心脑肺血管病杂志，2022，30(4)：23-28．DOI: 10.12114/j.issn.1008-5971.2022.00.108.

［19］高建平，王辉，王淑萍．老年肺癌患者胸腔镜不同术式术后肺功能、预后及LCQ评分对比［J］．中国老年学杂志，2023，43(5)：1064-1066．DOI: 10.3969/j.issn.1005-9202.2023.05.012.

［20］池旎．胸腔镜下肺癌的根治性手术编码探讨［J］．中国病案，2021，22(4)：39-41．DOI: 10.3969/j.issn.1672-2566.2021.04.015.