Factors influencing the hospitalization expenses of prostate cancer patients:An analysis based on quantile regression and random forest
Objective:To investigate the factors influencing the hospitalization expenses of PCa patients and provide some evi-dence for effectively reducing the direct economic burden of disease caused by laparoscopic radical prostatectomy(LRP).Methods:The author obtained the hospitalization data on 893 cases of PCa treated by LRP in a top tertiary hospital in Wuhan between January 1,2019 and June 30,2024.A database was constructed using the Stata 18.0 software,the Mann-Whitney U and Kruskal-Wallis H tests performed using the SPSS 27.0 and R 4.4.1 softwares,and the influencing factors for the hospitalization expenses of the patients ana-lyzed by multiple linear regression,quantile regression,and random forest algorithm.Results:Out-of-pocket payment accounted for 64.40％of the total hospitalization costs,averaging ¥60 794.9,with the per capita treatment cost(¥20 631.6),drug cost(¥ 15 046.2)and consumable cost(¥ 12 469.6)as the top 3 items of expenditure,accounting for 33.94％,24.75％and 20.51％,respectively.The results of multiple linear regression analysis showed that the number of hospital days(β=0.027),the number of comorbidities(β=0.008),the mode of admission(with the outpatient department as reference,the emergency depart-ment[β=0.128]and transfer from other institutions[β=0.251]),and the mode of surgery(with LRP[β=0.157]as refer-ence)all had statistically significant impacts on the sub-per capita hospitalization costs(P＜0.05).Quantile regression analysis re-vealed dramatic influence of the number of hospital days and surgical mode in different quantiles(P＜0.001),and random forest re-gression analysis showed the two influencing factors ranking the top two in terms of importance.Conclusion:PCa patients bear a heavy burden of hospitalization costs.The composition of the costs needs to be optimized,and efforts should be made to reduce the hos-pitalization expenses of the PCa patients by promoting the inclusion of medical consumables in medical insurance,facilitating the devel-opment of drugs and domestication of surgical robots,and reasonably shortening the hospital stay of the patients.
万方数据
维普
