肿瘤药学2025，Vol.15Issue(4)：559-564,6.DOI:10.3969/j.issn.2095-1264.2025.04.17
基于倾向性评分匹配和限制性立方样条研究血细胞刺激因子与肿瘤患者DRG超支之间的相关性
Association between hemocyte stimulating factors and DRG overspending in cancer patients based on propensity score matching and restricted cubic spline
摘要
Abstract
Objective To explore the association between hemocyte stimulating factors(HSFs)and diagnosis related group(DRG)overspending in cancer patients,providing a basis for drug control.Methods Patients entering the RE1A dis-ease group from January to December 2022 in a tertiary medical institution in Mianyang City,Sichuan Province,were used as the study data.The patients were divided into DRG overspending group and DRG not overspending group.Patients in the two groups were matched 1∶1 using propensity score matching(PSM),and the difference in the use of HSFs between the two groups was compared using the Wilcoxon rank sum test.Restricted cubic spline(RCS)and segmented multivariable Lo-gistic regression models were employed for examining the dose-effect relationship and threshold effect between HSFs and DRG overrun.Sensitivity analyses were performed using the multivariable Logistic regression model with pre-matching da-ta.Results A total of 1 729 patients were included in the study and 431 patients(24.93%)presented with DRG overspend-ing.After matching,there were 348 cases in each of the two groups,which were balanced at baseline between the two groups,and the SMD values for each baseline variable were less than 0.1.The Wilcoxon rank sum test showed a statistical difference in the amount of HSFs between the two groups(P<0.001).RCS model indicated a nonlinear relationship between HSFs and DRG overrun.When the expense of HSFs was≥1 261.80 yuan,HSFs were positively associated with the risk of DRG overrun(OR=1.001,95%CI:1.001～1.002,P=0.001).When the expense of HSFs was<1 261.80 yuan,no correlation existed between HSFs and the risk of DRG overrun(P=0.389).The results of the multivariable logistic regression model showed that the amount of HSFs was associated with DRG overspending(OR=1.16,95%CI:1.10～1.22,P<0.001).Conclusion A nonlinear relationship exists between HSFs and DRG overrun in tumor patients.When the expense of HSFs was≥1 261.80 yuan,HSFs are positively associated with DRG overrun.Therefore,clinics should strengthen the rational use of HSFs to reduce drug costs,thus reducing the risk of DRG overspending.关键词
肿瘤患者/血细胞刺激因子/DRG超支/倾向性评分匹配/限制性立方样条/多因素Logistic回归Key words
Cancer patients/Hemocyte stimulating factors/DRG overspending/PSM/RCS/Multivariable Logistic re-gression分类
医药卫生引用本文复制引用
赵德华,龙小庆,王继生,范红英,李旭,唐佳,王权印..基于倾向性评分匹配和限制性立方样条研究血细胞刺激因子与肿瘤患者DRG超支之间的相关性[J].肿瘤药学,2025,15(4):559-564,6.基金项目
北京医药卫生经济研究会药物经济学&真实世界研究&药政管理专项科研促进项目(BJHE2023-PRP-008). （BJHE2023-PRP-008）
