目的 了解宁夏细粒棘球蚴病手术患者住院费用情况及其影响因素，为降低患者疾病经济负担提供参考依据。 方法 收集宁夏2016—2021年接受外科手术的细粒棘球蚴病患者资料，包括基本情况、住院天数、住院费用等。利用SPSS20.0统计软件对数据进行统计分析，人均住院费用用中位数表示，组间比较采用Z检验或F检验。以住院费用为因变量，手术年份、性别、年龄、职业、文化程度、手术次数、医院级别、确诊至手术的时间间隔和住院天数为自变量进行多元线性logistic回归分析。 结果 共收集486例细粒棘球蚴病手术患者资料，住院费用合计1 139.1万元，人均23 438.7元，中位数为20 362.5元。住院费用主要包括17类，费用中位数居前3位的分别为药品费（8 030.0元）、材料费（5 000.0元）和手术费（3 436.4元）。男、女性住院费用中位数分别为20 126.1元、2 0931.4元，二者差异无统计学意义（Z = -0.552，P > 0.05）。40~59岁年龄组患者住院费用中位数最高，为20 835.5元；不同年龄组间住院费用差异有统计学意义（Z = 8.2，P < 0.05）。不同职业患者中，以其他职业患者的住院费用中位数最高，为22 655.0元；不同职业患者住院费用差异无统计学意义（Z = 1.838，P > 0.05）。文化程度为文盲的患者住院费用中位数最高，为23 286.4元，不同文化程度患者住院费用差异无统计学意义（Z = 6.729，P > 0.05）。确诊至手术的时间间隔 > 1年的患者住院费用（20 830.1元）高于间隔≤ 1年的患者（19 127.0元）（Z = -2.121，P < 0.05）。2016—2021年手术次数为1次的患者住院费用（20 274.3元）低于多次手术的患者（20 963.0元）（Z = -2.079，P < 0.05）。住院时间≤ 21 d的患者住院费用中位数（19 768.9元）低于住院> 21 d的患者（30 732.0元）（Z = 9 069.5，P < 0.01）。有医保的患者住院费用中位数（20 313.0元）与无医保的患者（29 798.5元）差异无统计学意义（Z = -1.392，P > 0.05）。行肝切除术的患者住院费用中位数最高（31 640.5元），不同手术方式的患者住院费用中位数差异有统计学意义（Z = 22.174，P < 0.01）。2016—2021年住院费用中位数呈逐年上升趋势，由2016年的17 689.5元上升至2021年的27 090.0元（Z = 27.560，P < 0.01）。省级、市级和县级医院住院费用中位数分别为26 227.0、16 979.0和12 988.1元，住院费用中位数随着医院级别的下降而降低（Z = 146.875，P < 0.01）。省级、市级医院住院时间平均为14 d，县级医院平均15 d，不同级别医院住院天数差异有统计学意义（F = 9.594，P < 0.05）。多因素logistic回归分析结果显示，手术方式、医院级别、住院天数和手术年份等4个因素与住院费用相关（P < 0.05）。486例患者中，国家棘球蚴病项目补助总额为2 732 224.6元，人均5 621.9元，中位数为6 000.0元；患者自付费用合计1 864 120.1元，人均8 176.0元，中位数为6 169.0元。经过医疗保险和国家棘球蚴病项目补助后，0自付患者最多，占53.1%（258/486），其次为自付费用1 000~4 999元、5 000~9 999元的患者，均占15.2%（74/486）；0自付患者占比由2016的41.7%（45/108）上升为2020年63.6%（35/55），2021年降为35.9%（23/64）。 结论 2016—2021年宁夏细粒棘球蚴病手术患者住院费用中位数呈逐年上升趋势，0自付患者比例逐年提高，但2021年下降至35.9%。建议应适当提高棘球蚴病防治项目补助标准，并引导患者就近选择定点医院治疗，以减少住院费用。

Objective To investigate the hospitalization expenses of patients with cystic echinococcosis undergoing surgery in Ningxia for providing reference basis to reduce the economic burden hospitalized patients. Methods Data from patients who underwent cystic echinococcosis surgery from 2016 to 2021 in Ningxia were collected, including the patient’s basic information, the number of hospitalisation days and the cost of surgery and other information. SPSS 20.0 statistical software was used for statistical analysis. The average hospitalization cost was expressed in median per capita. Z test and F test were used for comparison among groups. The hospitalization expense was assigned as dependent variable. The surgery year, gender, age, occupation, education level, number of operations, hospital grade, the time interval from diagnosis to operation and the days staying in hospital were taken as independent variables for multiple linear logistic regression analysis. Result A total of 486 patients’ information undergoing surgery were collected, of them the total hospital cost, average cost per patient and the median cost was 11.391 million yuan, 23 438.7 yuan, and 20 362.5 yuan. Hospitalization expense mainly include 17 categories, the top 3 median expenses were drug fee (8 030.0 yuan), consumble material fee (5 000.0 yuan) and operation fee (3 436.4 yuan). The median hospitalization expenses of men and women were 20 126.1 yuan and 20 931.4 yuan, respectively, with no significant difference (Z = -0.552, P > 0.05). The median hospitalization expenses of patients aged 40-59 years was the highest, which was 20 835.5 yuan. The difference of hospitalization expenses among different age groups was statistically significant (Z = 8.2, P < 0.05). Among different occupational patients, the median hospitalization expense of other occupational patients was the highest, which was 22 655.0 yuan. There was no statistically significant difference in hospitalization expense of different occupational patients (Z = 1.838, P > 0.05). The median hospitalization expenses of illiterate patients was the highest, which was 23 286.4 yuan. There was no statistically significant difference in hospitalization expenses of patients with different education levels (Z = 6.729, P > 0.05). The hospitalisation cost of patients with a time interval of more than 1 year from diagnosis to surgery (20 830.1 yuan) was higher than that of patients with an interval of ≤ 1 year (19 127.0 yuan) (Z = -2.121, P < 0.05). From 2016 to 2021, the hospitalization expense of patients with one operation (20 274.3 yuan) is lower than that of patients with multiple operations (20 963.0 yuan) (Z = -2.079, P < 0.05). The median hospitalization expense of patients with hospitalization time ≤ 21 days (19 768.9 yuan) was lower than that of patients with hospitalization time > 21 days (30 732.0 yuan) (Z = 9 069.5, P < 0.01). There was no statistically significant difference between the median hospitalization expenses of patients with medical insurance (20 313.0 yuan) and those without medical insurance (29 798.5 yuan) (Z = -1.392, P > 0.05). The median hospitalization cost of patients undergoing hepatectomy was the highest (31 640.5 yuan), and the median hospitalization cost of patients undergoing different surgical methods was statistically significant (Z = 22.174, P < 0.01). From 2016 to 2021, the median hospitalization expense increased from 17 689.5 yuan to 27 090.0 yuan (Z = 27.560, P < 0.01). The median hospitalization expenses of provincial, municipal and county hospitals were 26 227.0 yuan, 16 979.0 yuan and 12 988.1 yuan, respectively. The median hospitalization expenses decreased with the decline of hospital level (Z = 146.875, P < 0.01). The average days staying in provincial and municipal hospitals is 14 days, and that in county-level hospitals is 15 days. There was a statistically significant difference in the number of days staying in hospitals of different levels (F = 9.594, P < 0.05). Multivariate logistic regression analysis showed that four factors, including operation mode, hospital level, days staying in hospital and operation year, were related to hospitalization expenses (P < 0.05). Among 486 patients, the total subsidy of the national echinococcosis project, the average cost per person and the median cost per person were 2 732 224.6 yuan, 5 621.9 yuan and 6 000.0 yuan. The total, the average capita and median of out-of-pocket expenses for each patient were 1 864 120.1 yuan, 8 176.0 yuan and 6 169.0 yuan respectively. After medical insurance and national hydatid disease project subsidies, the majority had no out-of-pocket payment accounting for 53.1% (258/486), followed by 15.2% (74/486) paid 1 000-4 999 yuan out-of-pocket and 15.2% (74/486) paid 5 000-9 999 yuan out-of-pocket. The percentage of patients with no out-of-pocket fee increased from 41.7% (45/108) in 2016 to 63.6% (35/55) in 2020 and decreased to 35.9% (23/64) in 2021. Conclusion From 2016 to 2021, the median hospitalization expenses of patients for surgery on cystic echinococcosis in Ningxia increased year by year, while the proportion of patients with no out-of-pocket fees increased year by year, but decreased to 35.9% in 2021. It is suggested that the subsidy standard of the hydatid disease prevention and control project should be appropriately raised, and patients are encouraged to choose a nearby designated hospital for treatment, so as to reduce the hospitalization costs.