目的 本研究旨在探讨宫颈癌患者的住院费用构成的变动趋势，并探究影响住院费用的因素，以探寻如何进一步减轻患者及社会的经济负担，完善医院的费用管理制度，优化医疗服务价格体系，为控制医疗费用不合理增长提供参考依据。
方法 本研究收集了2013至2022年间中国6所三甲医院共6145名宫颈癌患者的人口学信息、治疗与诊断资料以及住院费用等数据。采用描述性统计方法来综述患者的基础资料和住院费用的各项组成，接着利用结构变动分析和灰色关联分析方法来分析各项费用的变化；随后，运用统计学方法中的非参数检验对住院费用进行单因素分析；最终，通过多因素线性逐步回归模型来筛选出影响住院费用变化的关键影响因素。
结果 2013-2022年，6145 例宫颈癌患者的平均年龄为59岁，平均住院天数为23天。住院总费用总体呈现出一个上升-稳定-下降的趋势，其年均结构变动度为10.28%，结构变动度较小；诊断费和药费是影响费用变动的两个显著因素。其中，2013-2022年诊断费和药费结构变动值呈正向变动，对住院费用结构变动贡献前三位的费用项目分别为诊断费（47.23%）、药费（27.28%）以及其他费用（14.70%），累计结构贡献率为 89.21%，是影响住院费用结构变动的主要因素。灰色关联分析显示，2013-2022年各单项费用与住院费用关联系数最大的为药费（0.913），关联系数最小的为综合医疗服务费（0.750）。单因素分析显示，年龄、职业、受教育程度、是否手术、病理诊断、疾病分期、住院天数以及医疗付费方式对宫颈癌患者住院费用有影响（P<0.001）。多元线性逐步回归分析显示住院患者疾病分期、住院天数、受教育程度、是否手术、医疗付费方式、年龄对宫颈癌患者住院费用有影响（P<0.001）。
结论 宫颈癌患者住院费用呈现出一个上升-稳定-下降的趋势，诊断费和药费是主要影响因素。疾病分期、住院天数、受教育程度、是否手术、医疗付费方式、年龄均对住院费用产生显著影响。管理应重点控制诊断费和药费，同时综合考虑患者个体特征和治疗方案，以提高医疗效率和质量。

Objective This study aimed to explore the trend of changes in the composition of hospitalization costs of cervical cancer patients and to investigate the factors affecting hospitalization costs, in order to explore how to further reduce the economic burden of patients and society, improve the cost management system of hospitals, optimize the pricing system of medical services, and provide a reference basis for controlling the irrational growth of medical costs.
Methods This study collected data on demographic information, treatment and diagnostic information, and hospitalization costs of a total of 6145 cervical cancer patients in six tertiary hospitals in China between 2013 and 2022. Descriptive statistics were used to summarize the basic information of the patients and the components of the hospitalization costs, followed by structural change analysis and gray correlation analysis to analyze the changes of the costs; then, non-parametric tests in statistical methods were used to conduct a univariate analysis of the hospitalization costs; and finally, a multifactorial linear stepwise regression model was used to filter out the key influences affecting the changes of the hospitalization costs.
Results From 2013 to 2022, the average age of 6145 cervical cancer patients was 59 years old, and the average hospitalization days were 23 days. The total hospitalization cost generally showed an upward-stabilizing-downward trend, and its average annual structural change was 10.28%, with a small structural change; diagnostic cost and drug cost were two significant factors affecting the cost change. Among them, the value of structural change of diagnostic fee and drug fee from 2013 to 2022 is positive, and the top three cost items contributing to the structural change of inpatient costs are diagnostic fee (47.23%), drug fee (27.28%), and other costs (14.70%), with a cumulative structural contribution rate of 89.21%, which is the main factor influencing the structural change of inpatient costs. Gray correlation analysis showed that the largest correlation coefficient between individual costs and hospitalization costs from 2013 to 2022 was drug costs (0.913), and the smallest correlation coefficient was comprehensive medical service costs (0.750). Univariate analysis showed that age, occupation, education level, whether surgery was performed, pathological diagnosis, cancer stage, hospitalization days, and medical payment method had an effect on hospitalization costs of cervical cancer patients (P<0.001). Multiple linear stepwise regression analysis showed that hospitalized patients' cancer stage, hospitalization days, education level, whether surgery, medical payment method, and age had an effect on the hospitalization cost of cervical cancer patients (P<0.001).
Conclusion The hospitalization cost of cervical cancer patients showed an increasing-stabilizing-decreasing trend, with diagnostic and pharmaceutical costs being the main influencing factors. Cancer stage, hospitalization days, education level, whether surgery, medical payment method, and age all had a significant impact on hospitalization costs. Management should focus on controlling diagnostic and pharmaceutical costs, while taking into account individual patient characteristics and treatment options to improve medical efficiency and quality.